Description & Requirements
Essential Duties and Responsibilities:ย
- Review requests for services including admission, discharges and continued stays for adherence to clinical criteria, state and federal policy, andย related requirements.
- Issue approvals, denials or recommendations based on contract requirements.
- Identify need for additional clinical documentation or consultation.
- Complete documentation of activities within contract systems.
- Communicate with providers, individuals and their designees, or state workers as required.
- Performs other related duties as assigned.
- Current Licensed Practical Nurse (LPN) license valid in the state of practice is required
- High School Degree or equivalent required
- Minimum 2 years of clinical experience required