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  • Prior Authorization Nurse

    Honolulu, HI 96817

    Posted: 01/10/2023 Industry: Registered Nurse (RN) Pay Rate: Up to $90k/year

    Job Description

    Looking for a FT LPN or RN for to provide prior authorization and utilization management support. The ideal candidate would have familiarity with Medicaid and Medicare regulations and great attention to detail.

    Prior Authorization Nurse Job Duties:
    • Conducts prospective review of authorization for inpatient and outpatient requests.
    • Make clinical decisions based on clinical guidelines and established criteria.
    • Prepares prior authorization documentation for review by UM Manager.
    • Provide resources to patients to meet healthcare needs.

    Job Requirements

    Prior Authorization Requirements:
    • 3-5 years or experience.
    • Active nursing license in the state of Hawaii. (RN/ LPN)
    • Computer literate. Proficient in MS Office Suite
    • Familiar with Medicaid and Medicare regulations.

    Call Express Healthcare at 808-792-7000 to schedule today!


    Meet Your Recruiter

    Aubrey Ide
    Credentialing Assistant

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