As part of the Pre-Access authorization team, The Prior Authorization RN provides timely review of authorization requests to ensure the request meets national standards and contractual requirements. Promotes the quality and cost effectiveness of patient care using clinical acumen in preparation of documentation, audits of patient records, and will assist management as needed.
Ensure timely initiation and authorization requests while meeting national standards and contractual requirements.
Prepare and compile necessary documentation to secure prior authorization for initiation and/or to obtain authorization for scheduled procedures.
Perform clinical reviews of authorization requests using appropriate criteria
Provide accurate and complete documentation with rationale used to approve request.
Collaborate with various staff within provider networks and care site business partners and care team to coordinate patient care
Equip and train prior authorization tech with needed resources
Located in Broomfield, CO.
Associate Degree in Nursing
Active Registered Nurse License
Minimum of two (2) years of experience in acute clinical nursing setting
Knowledge of utilization management and case management principles preferred
Minimum two years of prior authorization
4 years clinical experience
Certified Healthcare Access Associate (CHAA)
|Date Posted||June 5, 2018|
|Date Closes||July 5, 2018|
|Located In||Denver, CO|