Pyramid Consulting, Inc
Immediate need for a talented Prior Auth Nurse. This is a 06+months contract opportunity with long-term potential and is located in Columbus, OH (Remote). Please review the job description below and contact me ASAP if you are interested.
Key Skills; Care manager Prior authorization Medical knowledge Computer skills, medical knowledge, Care manager or clinical nursing experience Works well for this role: Prior Authorization Nurse, Medical Review Nurse, Appeals Nurse, Utilization Management or Quality Assurance Nurse Required: Requires Graduate from an Accredited School of Nursing or Bachelorās degree in Nursing and 2 ā 4 years of related experience. Required: Nursing Licensure
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.
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