Texas Licensed Clinical Review Nurse

Job Summary

A company is looking for a Clinical Review Nurse - Prior Authorization.

Key Responsibilities

• Performs medical necessity and clinical reviews of authorization requests
• Works with healthcare providers to ensure timely review of services
• Coordinates with interdepartmental teams to assess medical necessity of care

Required Qualifications, Training, and Education

• Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing
• 2 - 4 years of related experience
• Must be licensed in the state of Texas
• Clinical knowledge and ability to analyze authorization requests preferred
• Knowledge of Medicare and Medicaid regulations preferred