Florida Licensed Clinical Review Nurse

Company: VirtualVocations
Location: West Covina
Posted on: May 3, 2025

Job Description:

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
Coordinates with healthcare providers and interdepartmental teams to ensure timely review and authorization of services
Maintains clinical information in health management systems to ensure compliance with regulatory guidelines

Required Qualifications

Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing
2 - 4 years of related experience in clinical review or authorization processes
Knowledge of Medicare and Medicaid regulations preferred
Knowledge of utilization management processes preferred
LPN - Licensed Practical Nurse - State Licensure required

Keywords: VirtualVocations, Vista , Florida Licensed Clinical Review Nurse, Healthcare , West Covina, California

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