Pre-Authorization Nurse - Oklahoma City

Only for registered members Oklahoma City, United States

1 month ago

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Full time $71,100 - $97,800 (USD)

Become a part of our caring community and help us put health first

The Pre-Authorization Nurse coordinates care for MHS beneficiaries receiving care outside the MTF.

• Coordinate patient transfers and document appropriately in MSR.

• Perform prior authorization reviews according to established HUMANA GOVERNMENT BUSINESS contractual requirements and guidelines.
  • Perform accurate and timely assessment and concurrent review of outlier admissions using InterQual criteria.
  • Pend cases appropriately to second level review.

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