Remote Pennsylvania Licensed Authorization Registered Nurse

Job is Expired
Location: Nationwide
Compensation: Salary
Staff Reviewed: Thu, Jun 02, 2022
Job Summary

A health care provider is filling a position for a Remote Pennsylvania Licensed Authorization Registered Nurse.

Individual must be able to fulfill the following responsibilities:

  • Ensure clinical review process is followed in order to meet payor deadlines
  • Serve as a liaison between care managers and payors and facilitates payor/physician contact when indicated
  • Identify and assigns a root cause to each case to ensure denial reasons are tracked

Skills and Requirements Include:

  • RN required
  • Five years of acute care clinical experience, two years payer or care management experience
  • Licensed in the State of Pennsylvania
  • Prior utilization review experience
  • Understanding of clinical and care management process Knowledge of medical necessity criteria
  • Ability to apply InterQual criteria appropriately
COMPLETE JOB DESCRIPTION

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