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Prior Authorization RN

SCL Health System Denver, CO
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Job Description

Prior Authorization RN-18004670 

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. 

Required

  • 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

Preferred

  • Bachelors Degree

  • Certified Healthcare Access Associate (CHAA)

 

Organization

: Corporate, Various Locations

Primary Location

: CO-Denver/Boulder/Surrounding Areas-Broomfield
Department: SYS-RSC Pre Access

Schedule

: Full-time

Shift

: Day Shift

Job Posting

: Jun 4, 2018, 12:18:56 PM
FTE: 1.0

 Nursing Professional (RN)

Recruiter

: Mary Elizabeth Zook

Job Details

Date Posted June 5, 2018
Date Closes July 5, 2018
Requisition 18004670
Located In Denver, CO
SOC Category 00-0000.00
Location