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LPN Prior Authorization ( work from home PT)

TRC Staffing Services • Phoenix, AZ

Posted 3 days ago

Job Snapshot

$56,000.00 - $60,000.00 /Year
Healthcare - Health Services
Health Care
Relocation - No


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Job Description

LPN Prior Authorization 
(licensed Practical Nurse)
 This is a full time position with the opportunity to work from home 2 days per week.
Managed Care .Great team!

Please review these required qualifications prior to submitting a resume.

Qualifications of the LPN Prior Authorization 

Must reside in AZ ( Remote NAV for out of state residents
Must have a AZ nursing license active and in good standing
Must have experience in Prior Authorization, Utilization review, Concurrent Review
in a managed care environment.

Job Description for the LPN Prior Authorization 
Oversees the Utilization management activities by evaluating the necessity and efficiency of services through systemic monitoring of medical necessity and quality, while maximizing the appropriate level of care that correlates to the members benefit plan.

Job Requirements

Functions of the LPN Prior Authorization

  • Reviews and collect medical info in order to determine  the medical  necessity of services requested by applying the correct medical criteria.
  • Has direct  communication with healthcare providers involved with the care of the member to obtain complete and accurate info.
  • Ensure that services provided to members are within the benefit plan, and appropriate contracted providers are being utilized.
  • More detailed JD upon inquiry.

This is a Mon thru Friday Position. 8-5pm.  This is a Full time opportunity after ramp up time ( 6 months)  with  the option to  from home 2 days per week.
Great benefits and company!

Please call Cate for more details. 602-696-8151 mobile  (weekends ok)

This is a Direct Hire opportunity

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