Opportunity Description
**Become a part of our caring community**
The Pre-Authorization Nurse 2 reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Pre-Authorization Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
The Pre-Authorization Nurse 2 completes medical necessity and level of care reviews for requested services using clinical judgment and refers to internal stakeholders for review depending on case findings.
**Responsibilities**
+ Send and receive telephonic calls averaging 50% communication with providers
+ Educate providers on utilization and medical management processes
+ Enter and maintain pertinent clinical information in various medical management systems
+ Understand own work area professional concepts/standards, regulations, st...
The Pre-Authorization Nurse 2 reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Pre-Authorization Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
The Pre-Authorization Nurse 2 completes medical necessity and level of care reviews for requested services using clinical judgment and refers to internal stakeholders for review depending on case findings.
**Responsibilities**
+ Send and receive telephonic calls averaging 50% communication with providers
+ Educate providers on utilization and medical management processes
+ Enter and maintain pertinent clinical information in various medical management systems
+ Understand own work area professional concepts/standards, regulations, st...
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