Case Manager I (Prior-Authorization Nurse) occupation at Centene Corporation in Baton Rouge

Centene Corporation is presently looking of Case Manager I (Prior-Authorization Nurse) on Mon, 15 Oct 2012 21:07:44 GMT. Position Purpose: Review requests for prior authorization of medical services such as surgeries, pain management, home health care. Knowledge/Experience: At least two years clinical nursing experience. Experience utilizing medical management software programs. Position Responsibilities: • Review provider requests through fax or telephone to ensure medical necessity for services requiring...

Case Manager I (Prior-Authorization Nurse)

Location: Baton Rouge Louisiana

Description: Centene Corporation is presently looking of Case Manager I (Prior-Authorization Nurse) right now, this occupation will be placed in Louisiana. More details about this occupation opportunity kindly read the description below. Position Purpose:
Review requests for prior authorization of medical services such as surgeries, pain management, home health care.
Knowledge/Experience:
At least two years clinical nursing experience. Experience utilizing medical management software programs.

Position Responsibilities:

• Review provider requests through fax or telephone to ensure medical necessity for services requiring preauthorization.
• Utilize nationally recognized criteria to determine medical necessity of services requested.
• Refer provider requests appropriately to Medical Director when medical necessity of services is not met based on the criteria.
• Act as a clinical resource to referral staff
• Act as a liaison between the Provider and the Medical Director
• Data enters authorizations into the system.

Licenses/Certifications: RN, LPN or LVN required. Current state nursing license.
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If you were eligible to this occupation, please email us your resume, with salary requirements and a resume to Centene Corporation.

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This occupation starts available on: Mon, 15 Oct 2012 21:07:44 GMT

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