Clinical Review Nurse - Prior Authorization
Remote-NYremote$56K – $101K
Posted today · via Workday
About this role
Position Purpose: Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's benefit coverage. Provides recommendations to the appropriate medical team to promote quality and cost effectiveness of medical care. Key Details: This fully remote role requires an active New York RN license and the ability to work Monday through Friday, 8:30 AM to 5:00 PM ET, with a one-hour lunch break.…
What we'd score you on
reqspace match rubricFive dimensions, recruiter-grade. Upload your resume and we'll generate a written explanation of where you fit and where the gaps are.
1
Skills match
For this role: monday, teams
2
Level fit
We check your title trajectory against the seniority signal of the role.
3
Domain experience
Your work in the role's domain matters more than your years total. We weight recent and direct experience.
4
Recency
A skill you used last quarter weighs more than one from five years ago. We grade on recency, not lifetime.
5
Location fit
This role is remote-eligible. We factor in your stated location and time-zone overlap.
Score yourself on this role.
Free · no card · written explanation included
Skills in this role
Pulled from the job description. These are the keywords we'll weight when scoring your fit.
mondayteams