Clinical Review Nurse - Prior Authorization- IL
THIS ROLE IS REMOTE HOWEVER MUST RESIDE IN ILLINOIS TO BE CONSIDERED FOR THIS ROLE.
- Tuesday through Saturday
- 8:30 AM - 5:00 PM
- PAY RATE $44.00 PER HOUR
- Equipment Included
Job Summary
Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's benefit coverage. Provides recommendations to the appropriate medical team to promote quality and cost effectiveness of medical care.
Requirements
- An active and unrestricted LPN license for the state of IL
- 2 years of experience completing prior authorizations
- Knowledge of Medicare and Medicaid regulations
- Knowledge of utilization management processes
For immediate consideration, email resume and job title
Keyera West
Job Type: Full-time
Pay: $44.00 per hour
Expected hours: 40 per week
Benefits:
- Health insurance
Education:
- Associate (Preferred)
Experience:
- Prior Authorization : 2 years (Required)
- Medicare: 1 year (Required)
- Utilization management: 1 year (Preferred)
License/Certification:
- LPN (Required)
Location:
- Illinois (Required)
Work Location: Remote
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