RN or LVN Care Review Clinician Job

RN OR LVN CARE REVIEW CLINICIAN/PRIOR AUTHORIZATION needed for a Contract opportunity with Yoh's client located in Long Beach, CA.

The Big Picture - Top Skills You Should Possess:

- RN or LVN License in State of CA
- Prior Authorization Experience
- Must have Utilization Review experience in a Managed Care Setting

What You'll Be Doing:

- Provide daily review and evaluation of members that require hospitalization
- Provide concurrent review and prior authorizations to Utilization Management Department
- Identify appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures

What You Need to Bring to the Table:

- Registered Nurse or Licensed Vocational Nurse Licensure in State of CA (Active and in Good Standing)
- Must have two to five (2 - 5) years of Prior Authorization in a Managed Care Setting
- Must have Experience with Inter-Qual and CMS guidelines
- Knowledge of applicable state, and federal regulations
- Excellent verbal and written communication skills
- Proficient in Microsoft Office: Word and Excel

OPPORTUNITY IS CALLING, APPLY NOW!

RECRUITER: Christine Mosessian

Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer, M/F/D/V.

J2W: HC

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SFSF: HC