Prior Authorization Review Nurse

Job description

·  Job Description:

DXC Technology (NYSE: DXC) is the world’s leading independent, end-to-end IT services company, helping clients harness the power of innovation to thrive on change. Created by the merger of CSC and the Enterprise Services business of Hewlett Packard Enterprise, DXC Technology serves nearly 6,000 private and public-sector clients across 70 countries. The company’s technology independence, global talent and extensive partner alliance combine to deliver powerful next-generation IT services and solutions. DXC Technology is recognized among the best corporate citizens globally.

This position works within a team environment to support Nevada Medicaid with a focus on Personal Care Services. This is a day shift position and is Monday through Friday except for state holidays. The position allows nurses to use their medical judgement and assessment skills to determine and provide input regarding the level of need for Medicaid recipients to maintain stability.  This is an exciting position allowing for growth and increased responsibility as desired by the nurse.

Responsibilities:

·  Medical review of requests for services covered under Nevada Medicaid.
·  Work within the team environment to meet the needs of the community while maintaining fiscal responsibility for the state.
·  Review data and make independent decisions once trained.
·  Participates and contributes in process review and improvement initiatives.
·  Handle escalated issues with minimal assistance.

Education and Experience Required:

·  Must have an LPN or RN unrestricted license
·  Typically, 5-8 years of working experience.

Knowledge and Skills:

·  Knowledge of commercial and government insurance programs helpful.
·  Ability to plan and meet deadlines for projects/issues.
·  Demonstrated ability to work effectively in a team and independently.
·  Develop subject matter expertise regarding policies and procedures.
·  Ability to research and resolve inquiries by identifying trends and utilizing available resources.
·  Self-motivated with strong time management and organizational skills.
·  Provide assistance to peers.