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PRIOR AUTHORIZATION NURSE - (19200)

Universal Health Services


Location:
El PASO, TX
Date:
02/16/2018
2018-02-162018-03-17
Job Code:
19200
Universal Health Services
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Job Details

Deltek Talent Management - PRIOR AUTHORIZATION NURSE - (19200)

Job Details


PRIOR AUTHORIZATION NURSE - (19200)

Facility Name
EL PASO BEHAVIORAL HEALTH SYS
Location
El PASO, TX 79902 US (Primary)
Career Area
Nursing
Category
Licensed Practical Nurse (LPN)
Job Description

Under the general direction/supervision of the Utilization Management Director, the Prior Authorization Nurse conducts prospective review of medication authorization requests.

  1. Ensures authorizations are processed according to established timelines, benefit coverage, and medical necessity criteria within the appropriate insurance guidelines.

  2. Provides clear and accurate documentation on rational for approving request.

  3. Accurately and consistently apply appropriate clinical review guidelines for authorization requests.

  4. Provides timely responses to inquiries from insurance plans and providers concerning members regarding the prior authorization requests.

  5. Works closely with the interdisciplinary team as needed.

  6. Other duties as requested or assigned.::

Job Requirements

Experience: Knowledge of insurance requirements and benefits that apply to the utilization management process- preferred.  Prior managed care experience, discharge planning, or utilization management- preferred.  

License:   Current unrestricted Licensed Vocational Nurse (LVN) license for the State of Texas.

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