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.