Spectrum Health Authorization Nurse Coordinator - Home Health - Temporary (Priority Health) in Grand Rapids, Michigan

Facility: Priority Health - GRAND RAPIDS, MI

Department: Ph-Medical Operations

Category: Other

Classification: Contingent/Temporary no Benefits (C4)

This position is responsible for making decisions on authorization requests. Decisions will be made by utilizing clinical expertise, reviewing medical documentation, determining need, considering alternatives, and according to Medical Policy, Interqual Criteria, Medicare Guidelines, and plan documents. Case presentation will be made to medical director for all complex requests and when medical criteria is not met for final determination.

Basic Qualifications:

Education - High School Diploma or equivalent

Experience - 5 years of experience typically gained through skills/knowledge/abilities in A minimum of 5 years clinical experience

Licenses -

Licensed Practical Nurse in MI (LPN)

Preferred Qualifications:

Experience - 1 year of experience typically gained through skills/knowledge/abilities in One year previous physician office experience 1 year of experience typically gained through skills/knowledge/abilities in One year previous insurance authorization experience

Spectrum Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, sexual orientation, veteran status, or any other legally protected category.