Title: Clinical Review Nurse - Prior Authorization 
Location: Remote – PST and CST (No CA and NY candidates please)
Duration: 12 Months
Job description:
 

Candidate Requirements
Education/Certification	Required: Requires Graduate from an Accredited School of Nursing or Bachelor’s degree in Nursing and 2-4 years of experience			Preferred:
Licensure	Required: Required: RN- Registered Nurse/LPN - Licensed Practical Nurse - State Licensure required Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in accordance with regulatory guidelines and criteria			Preferred: NV or Compact RN license
Years of experience required: Nice to haves: 2-4 years of related experience. Prior PA experience required, experience in InterQual/ Milliman, One Note, knowledge of Utilization Management (policies/regulations), at least 1 candidate must have NV license.     Disqualifiers: California and NY candidates   Additional qualities to look for: Team player, flexible
Top 3 must-have hard skills stack-ranked by importance		1	Prior preservice or prior authorization in Utilization Management department experience required. There is no exception to this required minimum skills experience.
		2	Experience in InterQual or Milliman
		3	Organizational skills, detailed oriented, able to work independently and make decision in fast paced role, disciplined, technology dexterity, change management minded, Customer centricity minded.

 
 
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws.This position's pay range is $37.00/hr - $39.00/hr.