Pre-Authorization Nurse - Oklahoma City
1 month ago

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.
Job description
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