Clinical Review Nurse
Clinical Review Nurse
Pacer Staffing LLC
United States
See who Pacer Staffing LLC has hired for this role
Job Title: Clinical Review Nurse
Location: Remote MO
Duration: 2 months
Shift Timing: Monday through Friday 8:00am to 5:00pm CST.
Some flexibility depending on the time zone, 9 - 6 7 - 4 10 -7 is also a last resort but an option.
Summary
Location: Remote MO
Duration: 2 months
Shift Timing: Monday through Friday 8:00am to 5:00pm CST.
Some flexibility depending on the time zone, 9 - 6 7 - 4 10 -7 is also a last resort but an option.
Summary
- Prior authorization nurse is supporting a Medicaid line of business.
- Reviewing outpatient service requests to determine if they are medically necessary.
- Reviewing cases in InterQual
- Working with medical directors and therapists
- Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's benefit coverage.
- Provides recommendations to the appropriate medical team to promote quality and cost effectiveness of medical care.
- Utilization management cases
- Fast paced environment
- 36 hours turnaround time from start to finish with utilization management cases. (Start to finish)
-
Seniority level
Entry level -
Employment type
Full-time -
Job function
Health Care Provider -
Industries
Staffing and Recruiting
Referrals increase your chances of interviewing at Pacer Staffing LLC by 2x
See who you knowGet notified about new Registered Nurse jobs in United States.
Sign in to create job alertSimilar jobs
People also viewed
-
Remote Nurse Triage Position
Remote Nurse Triage Position
-
Remote Nurse Triage Position
Remote Nurse Triage Position
-
Nurse Member Advocate
Nurse Member Advocate
-
Nurse Triage - Remote | WFH
Nurse Triage - Remote | WFH
-
Remote Nurse Triage Position
Remote Nurse Triage Position
-
Clinical Denials and Appeals RN - Remote
Clinical Denials and Appeals RN - Remote
-
Prior Authorization Nurse
Prior Authorization Nurse
-
RN Daytime Triage Remote
RN Daytime Triage Remote
-
Care Management RN (Compact License)
Care Management RN (Compact License)
-
Clinical Review Nurse
Clinical Review Nurse
Looking for a job?
Visit the Career Advice Hub to see tips on interviewing and resume writing.
View Career Advice Hub