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Licensed Clinical Review Nurse image - Rise Careers
Job details

Licensed Clinical Review Nurse - job 1 of 3

Job Summary

A company is looking for a Clinical Review Nurse - Prior Authorization (Medicaid).

Key Responsibilities
  • Analyze prior authorization requests to determine medical necessity and appropriate level of care
  • Coordinate with healthcare providers and interdepartmental teams to ensure timely review and authorization of services
  • Document and maintain member clinical information in health management systems to comply with regulatory guidelines
Required Qualifications
  • Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing
  • 2 - 4 years of related experience preferred
  • Clinical knowledge and ability to analyze authorization requests preferred
  • Knowledge of Medicare and Medicaid regulations preferred
  • LPN or RN license required, depending on the location

Average salary estimate

$70000 / YEARLY (est.)
min
max
$60000K
$80000K

If an employer mentions a salary or salary range on their job, we display it as an "Employer Estimate". If a job has no salary data, Rise displays an estimate if available.

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FUNDING
SENIORITY LEVEL REQUIREMENT
TEAM SIZE
No info
EMPLOYMENT TYPE
Full-time, remote
DATE POSTED
May 29, 2025

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