Management/Prior Authorization nurse in a managed care payer preferred. One year experience as a case manager in a payer... as needed for the clinical review process Conducts pre-authorization and concurrent clinical reviews requests for services such as DME...
appropriate course of care in a given situation Perform medical chart review that includes a review of current and prior patient... in. Required Qualifications: Undergraduate degree or 4+ years of equivalent nursing experience Current unrestricted RN nurse license...
appropriate course of care in a given situation Perform medical chart review that includes a review of current and prior patient... in. Required Qualifications: Undergraduate degree or 4+ years of equivalent nursing experience Current unrestricted RN nurse license...
's, Recertification prescriptions, medication refill requests, medication prior authorization requests, utility letters, housing letters.... The MA may be required to process prior authorization for diagnostic imaging such as CT, PET, or other tests and schedule...