Oklahoma Licensed Clinical Review Nurse - Ontario California

Company: VirtualVocations
Location: Ontario, California
Posted On: 01/26/2025

A company is looking for a Clinical Review Nurse - Prior Authorization.



Key Responsibilities

Analyze prior authorization requests to determine medical necessity and appropriate level of care
Coordinate with healthcare providers and teams to ensure timely reviews and authorizations
Document and maintain member clinical information in compliance with regulatory guidelines


Required Qualifications

Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing
2 - 4 years of related experience preferred
Knowledge of Medicare and Medicaid regulations preferred
Knowledge of utilization management processes preferred
Valid Oklahoma or compact nursing license required More...

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