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Texas Licensed Registered Nurse - Prior Authorization in Austin, TX at MMC Group

Date Posted: 12/4/2018

Job Snapshot

Job Description

MMC Group is looking for Texas Licensed Registered Nurses for contract opportunities in Austin Texas
These are non clinical positions but you must be able to work a 10am to 7pm shift. 
In this position, you will be conducting pre-service, concurrent/ retrospective reviews for insurance claims
You will collaborate with healthcare providers to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources.
You will also ensure medically appropriate, high quality, cost effective care through assessing the medical necessity of outpatient services, out of network services, and appropriateness of treatment setting within the scope of professional limitations by utilizing the applicable rules of the Texas Administrative Code (TAC).
These will be 8 hour shifts, unless overtime is needed and approved. 

Job Requirements
Experience needed: 
  • Must be a Licensed Registered Nurse in the state of Texas
  • Comprehensive Care Program Experience highly preferred: Private Duty nursing. Home Health experience. Comprehensive Care Program Experience. 


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