Job Details

ID #51547804
Estado Delaware
Ciudad Newark
Full-time
Salario USD TBD TBD
Fuente Actalent
Showed 2024-04-24
Fecha 2024-04-24
Fecha tope 2024-06-23
Categoría Etcétera
Crear un currículum vítae
Aplica ya

Clinical Review Nurse - Prior Authorization

Delaware, Newark, 19702 Newark USA
Aplica ya

Description: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.Must Haves:2-4 years of related experienceGraduate from an Accredited School of Nursing or Bachelors degree in NursingLPN License - DE or Compact license required.Prior Authorization Experience required.Experience in InterQual Milliman Understanding State PoliciesSkills:Prior Authorization, Clinical review, Licensed Practical Nurse, LPN, InterqualAbout Actalent Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.Diversity, Equity & Inclusion At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

Hiring diverse talent

Maintaining an inclusive environment through persistent self-reflection

Building a culture of care, engagement, and recognition with clear outcomes

Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email [email protected] (%[email protected]) for other accommodation options.

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