(2) Prior Authorization, Case Managers - Full-time / Part-time

We are currently looking for (2) Prior Authorization Nurses.

Job Description:

Review requests for prior authorization of medical services for multiple lines of business such as DME, home health, therapy, out of network, in patient and elective inpatient, imaging and medicaid.

• Review provider requests through fax or telephone to ensure medical necessity for services requiring pre-authorization.
• Utilize nationally recognized criteria to determine medical necessity of services requested.
• Refer provider requests appropriately to Medical Director when medical necessity of services is not met based on the criteria.
• Act as a clinical resource to referral staff

Requirements:

Knowledge/Experience: At least two years clinical nursing experience.

Licenses/Certifications: RN or LPN required. Current state nursing license.

About Aerotek:

Our people are everything. As a Best of Staffing® Client and Talent leader, Aerotek® Inc. has distinguished itself as a leader in recruiting and staffing services, by having a deep understanding of the intersection of talent and business. As a strategic partner to more than 17,000 clients and 300,000 contract employees every year, Aerotek's people-focused approach yields competitive advantages for its clients and rewarding careers for its contract employees. Headquartered in Hanover, Md., Aerotek operates a network of over 230 non-franchised offices with more than 6,000 internal employees dedicated to serving our customers. Aerotek is an operating company of Allegis Group, a global talent solutions provider. To learn more, visit .

Aerotek is acting as an Employment Agency in relation to this vacancy.