Job Description: Job Title: Utilization Review Clinician / Clinical Review Nurse Prior Authorization Location... (clinical experience required). Experience in utilization review, medical necessity determination, or prior authorization...
performing clinical reviews for prior authorization requests utilizing policies, Interqual, sending to the MD... with Potential to extend and/or convert if position has permanent openings. Job Purpose: Purpose: to perform prior authorization...
all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance... and review prior and continued stay requests for mental health and substance abuse outpatient services. They will analyze member...