Pre-Authorization Nurse LPN

About This Role

Process pre-authorization requests for elective services, ensuring departmental compliance and continuity of care for members. This role involves communicating with Utilization Management Coordinators and Care Managers.

Responsibilities

• Process all requests for elective services in accordance with departmental criteria and guidelines
• Communicate all elective hospital admissions to the appropriate Utilization Management Coordinator and/or Care Manager to ensure timely receipt of information and continuity of members care

Requirements

• Current LPN NY license and registration
• Minimum of 1-3 years Medical/Surgical nursing experience
• Working knowledge of Windows, Word and Excel
• Knowledge of current standards of medical practice and healthcare delivery systems
• Excellent written and oral communication skills
• Good analytical abilities

Qualifications

• Graduate of an accredited Practical Nursing Program
• Minimum of 1-3 years Medical/Surgical nursing experience

Nice to Have

• Prior managed care experience
• Familiarity with Utilization management processes

Skills

* Required skills