Florida Licensed Clinical Review Nurse
Company: VirtualVocations
Location: Whittier
Posted on: February 2, 2025
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Job Description:
A company is looking for a Clinical Review Nurse - Prior
Authorization.
Key Responsibilities
Analyze prior authorization requests to determine medical necessity
and appropriate level of care
Coordinate with healthcare providers and interdepartmental teams to
ensure timely review and authorization of services
Document and maintain member clinical information in health
management systems to ensure regulatory compliance
Required Qualifications, Training, and Education
Graduate from an Accredited School of Nursing or Bachelor's degree
in Nursing
2 - 4 years of related experience in nursing
Current LPN or RN license required based on state regulations
Clinical knowledge with the ability to analyze authorization
requests
Knowledge of Medicare and Medicaid regulations preferred
Keywords: VirtualVocations, Palm Desert , Florida Licensed Clinical Review Nurse, Healthcare , Whittier, California
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