LPN Clinical Review Nurse - San Diego California

Company: VirtualVocations
Location: San Diego, California
Posted On: 02/02/2025

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 to ensure timely reviews and authorized care for members
Document and maintain member's clinical information to ensure 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 in clinical settings
Licensed Practical Nurse (LPN) State Licensure required
Clinical knowledge with the ability to analyze authorization requests preferred
Knowledge of Medicare and Medicaid regulations preferred More...

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