What are the responsibilities and job description for the Clinical - Clinical Review Nurse - Prior Authorization position at Axelon?
Location : Remote, Must Live in AZ
Shift : Training may be Mon - Fri 8am - 5pm - 3 weeks MUST ATTEND; Regular shift will be Mon - Fri 830am - 5pm MST
Duration : 3 month, with potential to extend. This role is a Temp covering for a FTE on Leave
- Must have rizona LPN / RN License
Walk me through the day-to-day responsibilities of this the role and a description of the project :
Describe the performance expectations / metrics for this individual and their team :
Job Description : Position Purpose :
Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's benefit coverage. Provides recommendations to the appropriate medical team to promote quality and cost effectiveness of medical care.
Education / Experience : Requires Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing and 2 - 4 years of related experience. Required Skills / Experience : Preferred Skills / Experience : 1. rizona LPN / RN License 1. Team member 2. General computer skills 2. Willingness to learn 3. 3. 2 years of related experience Education Requirement : rizona LPN / RN License Education Preferred : Software Skills Required : Microsoft office
