Registered Nurse RN Prior Authorization Medical Management Services
Banner Health(1 month ago)
About this role
A Registered Nurse on the Prior Authorization Medical Management team supports Medicare managed care plans by reviewing and adjudicating medical pre-service requests. The role works within Banner Plans & Networks to ensure determinations align with plan policies and regulatory requirements and interfaces with providers, vendors, and members. This position is offered as a remote opportunity for eligible states with defined AZ-time hours.
Required Skills
- Prior Authorization
- Case Management
- Care Coordination
- Utilization Management
- Clinical Assessment
- Documentation
- Provider Communication
- Medicare
- Concurrent Review
- Medical Necessity
Qualifications
- Registered Nurse (RN) License
- Bachelor's Degree
- Certified Case Manager (CCM)
- MCG Certification
- RN-BC
- CMCN
About Banner Health
bannerhealth.comBanner Health makes health care easier, so your life can be better. Find a provider, schedule an appointment, or find the nearest Banner Health location near you.
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