PHRN - Prior Authorization

About the job PHRN - Prior Authorization

Quality Auditor hiring Clinical Authorization Process.

Onsite, Night Shift, Mon-Friday

Qualifications

• Must hold an active PHRN license (not a USRN license holder)
• Relevant experience as a Quality Auditor in Clinical Services within a healthcare BPO environment; alternatively, 4 to 7 years of specialized experience in Clinical Authorization or Utilization Review is preferred
• Strong familiarity with EPIC , MCG , or InterQual guidelines required
• Demonstrated job stability , with a consistent employment history and minimal transitions

Job Description

I. Audit

• Completing QA audits for their processes by ...