JOB SUMMARY. The Prior Authorization/Utilization Review Nurse is responsible for carefully recording information regarding patient care on the back end of the clinic and doctor's office visits in hopes of keeping healthcare costs low for both patients and the organization. ESSENTIAL JOB FUNCTIONS. Ensure the highest quality of patient care through systematic reviews of the patient's medical records and active communication with the patient, famil...
Position Summary. The role of the Nurse Reviewer is to promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to prior authorization specialty referral requests as well as acute inpatient admission. The Nurse Reviewer will review for appropriate care and setting, and following guidelines/policies, will approve services when indicated. If not indicated, Nurs...
