Prior Authorization RN

More Insight of Daily Responsibilities:

Review cases for in patients/in hospital: skilled care, acute rehab and long term acute care 

• Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina members as part of the Utilization Management team.

• Identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures.

• Participates in interdepartmental integration and collaboration to enhance the continuity of care for Molina members including Behavioral Health and Long Term Care.