Clinical nurse rn Jobs in Charlotte, NC

A company is looking for a Clinical Review Nurse - Prior Authorization. Key Responsibilities Performs medical necessity and clinical reviews of authorization requests Coordinates with healthcare providers to ensure timely review of services Collects and maintains member's clinical information in health management systems Required Qualifications, Training, and Education Active RN license in Oregon, California, Texas, or Mississippi 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 Understanding of utilization management processes preferred