Delaware Licensed Clinical Review Nurse

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

Key Responsibilities

Analyzes prior authorization requests to determine medical necessity and appropriate level of care

Provides recommendations to medical teams to promote quality and cost-effective care

Documents and maintains members' clinical information in health management systems for compliance

Required Qualifications

Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing

2-4 years of related experience preferred

Licensed Practical Nurse (LPN) - State Licensure required

RN license required for specific locations