Florida Licensed Pre-Authorization Nurse - Delray Beach Florida

Company: VirtualVocations
Location: Delray Beach, Florida
Posted On: 01/22/2025

A company is looking for a Pre-Authorization RN to review prior authorization requests for appropriate care and setting.



Key Responsibilities

Completes medical necessity and level of care reviews for requested services using clinical judgment
Refers cases to internal stakeholders and educates providers on utilization and medical management processes
Enters and maintains pertinent clinical information in various medical management systems


Required Qualifications

Licensed Registered Nurse (RN) in Florida or a compact state with no disciplinary action
Residence in NC, SC, FL, or GA
2 or more years of Utilization Management (UM), Pre-Auth, or managed care review experience
1 or more years of acute and/or critical care clinical experience
Proficient with MS Office Word, Excel, and Outlook More...

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