RN Prior Authorization Nurse

Job Summary

A company is looking for a RN Prior Authorization Nurse with a Healthcare Compact License.

Key Responsibilities

• Perform utilization review activities, including pre-certification and concurrent reviews
• Determine medical necessity of requests by applying medical criteria and guidelines
• Document and communicate all utilization review activities and outcomes

Required Qualifications

• Current, unrestricted Texas RN license or compact license
• 2+ years of experience in managed care or 5+ years of nursing experience
• Proficient in PC software computer skills