Job Description
Title - Clinical Review Nurse- Prior Authorization
Duration - 6 months
Shift - 8 am- 5 pm
Location - Remote OH
Pay rate: XX40-42.00XX
Responsibilities
- BHP Prior Authorization Clinical Review Nurse
- Biweekly team huddles (virtual), and attention to emailed team instructions, proficient in toggling between multiple systems
- Review of prior auth requests for Medicaid Line of Business.
- To assist the PA Team reviewing a backlog of requests from providers
Must haves:
- Computer skills, medical knowledge,
- Care manager or clinical nursing experience
Nice to haves:
- Works well for this role: Prior Authorization Nurse, Medical Review Nurse, Appeals Nurse, Utilization Management or Quality Assurance Nurse
Performance indicators:
- (Meet expectations) Quality documentation, timely processing of up to 18 authorizations per day on average, team player with positive attitude
Top 3
- Computer skills
- Prior authorization previous experience
- Medical knowledge
Education
- Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing and 2 4 years of related experience.
Job Tags
Remote job, Shift work,