Clinical Review Nurse- Prior Authorization Job at Pacer Group, Ohio

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  • Pacer Group
  • Ohio

Job Description

Title - Clinical Review Nurse- Prior Authorization

Duration - 6 months

Shift - 8 am- 5 pm

Location - Remote OH

Pay rate: XX40-42.00XX

Responsibilities

  • BHP Prior Authorization Clinical Review Nurse
  • Biweekly team huddles (virtual), and attention to emailed team instructions, proficient in toggling between multiple systems
  • Review of prior auth requests for Medicaid Line of Business.
  • To assist the PA Team reviewing a backlog of requests from providers

Must haves:

  • Computer skills, medical knowledge,
  • Care manager or clinical nursing experience

Nice to haves:

  • Works well for this role: Prior Authorization Nurse, Medical Review Nurse, Appeals Nurse, Utilization Management or Quality Assurance Nurse

Performance indicators:

  • (Meet expectations) Quality documentation, timely processing of up to 18 authorizations per day on average, team player with positive attitude

Top 3

  • Computer skills
  • Prior authorization previous experience
  • Medical knowledge

Education

  • Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing and 2 4 years of related experience.

Job Tags

Remote job, Shift work,

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