Job Summary
A company is looking for a Pre-Authorization Registered Nurse.
Key Responsibilities
- Review prior authorization requests and determine appropriate care and setting
- Conduct medical necessity and level of care reviews using clinical judgment
- Educate providers on utilization and medical management processes
Required Qualifications
- Licensed Registered Nurse (RN) in Kentucky with no disciplinary action
- Minimum 3 years of experience as a nurse in a clinical setting
- Strong proficiency with MS Office Suite and ability to learn multiple systems
- Experience with the development and implementation of policies and procedures
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