HarrisburgRecruiter
the smart solution for Harrisburg jobs

Prior Authorization Nurse I

Company: Centene Corporation
Location: Harrisburg
Posted on: February 13, 2019

Job Description:

Description: Position Purpose: Promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to prior authorization requests. Perform telephonic review of prior authorization requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinations Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings Collaborate with various staff within provider networks and case management team electronically or telephonically to coordinate member care Educate providers on utilization and medical management processes Provide clinical knowledge and act as a clinical resource to non-clinical team staff Enter and maintain pertinent clinical information in various medical management systems Qualifications:
--Education/Experience: Graduate from an Accredited School of Nursing. Bachelor's degree in Nursing preferred. 2+ years of clinical nursing experience. Knowledge of healthcare and managed care preferred. Licenses/Certifications: Current State LPN/LVN or RN license. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Keywords: Centene Corporation, Harrisburg , Prior Authorization Nurse I, Healthcare , Harrisburg, Pennsylvania

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Healthcare Jobs


Psychiatry Physician Child & Adolescent Psychiatrist - Physicians Only Apply - Perm
Description: A Psychiatry Physician Child Adolescent Psychiatrist practice is seeking a qualified physician for Lancaster, PA. This and other physician jobs
Company: Finders Firm
Location: Lancaster
Posted on: 02/18/2019

Registered Nurse (RN) MedSurge Full Time Permanent
Description: Registered Nurse RN MedSurge Full Time Permanent MedSurge RN needed in Lancaster with competitive pay and benefits Ring home priceless memories of the expected - farmlands, family-style feasts and (more...)
Company: Blue Royal Staffing
Location: Lancaster
Posted on: 02/18/2019

Travel RN-Dialysis Nurse - Acute Travel Dialysis Nurse needed for Lanc
Description: For this exciting assignment in Pennsylvania, a qualified candidate would need a Pennsylvania license and at least a year of dialysis experience. This thirteen week assignment will be in an inpatient (more...)
Company: Foundation Medical Staffing
Location: Lancaster
Posted on: 02/18/2019


Registered Nurse (Leesburg,VA)
Description: The Registered Nursing RN is responsible to perform a competent level of nursing care as demonstrated by the critical thinking model known as the nursing process. The standards of practice assessment, (more...)
Company: Sentara - Digital CWS
Location: Leesburg
Posted on: 02/18/2019

Registered Nurse - BelleHarbour Emergency Department (Leesburg,VA)
Description: The Registered Nursing RN is responsible to perform a competent level of nursing care as demonstrated by the critical thinking model known as the nursing process. The standards of practice assessment, (more...)
Company: Sentara - Digital CWS
Location: Leesburg
Posted on: 02/18/2019

Physician: Outpatient Facilities in Virginia Needs Primary C
Description: Employer is currently assisting a Virginia leading not-for-profit healthcare provider with their search for a family practice or internal medicine physician with at least two years of experience. The (more...)
Company: CompHealth
Location: Leesburg
Posted on: 02/18/2019

Physician: Outpatient Facilities in Virginia Needs Primary Care Physic
Description: Physician: Outpatient Facilities in Virginia Needs Primary Care Physic CompHealth is currently assisting a Virginia leading not-for-profit healthcare provider with their search for a family practice or (more...)
Company: CompHealth
Location: Leesburg
Posted on: 02/18/2019

Acute Dialysis RN Jefferson Torresdale
Description: Job DescriptionHospital Services Acute Registered NurseDaVita is seeking a Registered Nurse who is looking to give life to patients in an Acute Hospital setting. RNs in this role work autonomously (more...)
Company: Da Vita
Location: Lancaster
Posted on: 02/18/2019

Tech/Cath Lab Invasive Technologist (910206)
Description: JOB CODE: 910206 Tech/Cath Lab Invasive Technologist LOCATION: Berks County PA Join a strong regional integrated hospital system with a rich history of providing high-quality, cost effective care (more...)
Company: Veritas Global Consulting Group, LLC
Location: Lancaster
Posted on: 02/18/2019

Registered Nurse - (RN) - Labor & Delivery (Chantilly,VA)
Description: The Registered Nursing RN is responsible to perform a competent level of nursing care as demonstrated by the critical thinking model known as the nursing process. The standards of practice assessment, (more...)
Company: Sentara - Digital CWS
Location: Chantilly
Posted on: 02/18/2019

Log In or Create An Account

Get the latest Pennsylvania jobs by following @recnetPA on Twitter!

Harrisburg RSS job feeds