Senior Integrated Care Manager, specializing in Utilization review, the registered nurse will be responsible for utilization review services within the scope of licensure.
Conducts primary function of prior authorization for inpatient and outpatient reviews both initial and concurrent continued stay review.
Reviews for appropriateness of treatment setting to ensure compliance with applicable criteria, and regulatory requirements.
Responsible for written and /or verbal communication of pertinent clinical information.
Location: Hybrid in Norfolk, VA; reports to Sentara Patient Accounting.
Requirements
Bachelors Degree in Nursing REQUIRED
Registered Nurse (RN) License (Compact or Virginia) REQUIRED