Registered Nurse Authorization

To support a growing healthcare team, the full-time Authorization Nurse will work remotely to obtain referrals and authorizations for acute admissions and hospital services while leveraging clinical expertise and payer regulations to assess medical necessity. Key responsibilities Serve as a liaison between care managers and payors, facilitating communication regarding medical appropriateness Collaborate with departments to ensure all necessary documentation is obtained to support authorizations and level of care Monitor and evaluate processes for improvement related to payer-specific authorization and maintain current knowledge of regulatory guidelines Required qualifications RN required; BSN or Bachelor's degree preferred 5 years of acute care clinical experience 2 years of payer or care management experience Understanding of medical necessity criteria (InterQual) and prior utilization review experience Licensed in practicing state