- Centene Corporation (New York, NY)
- …**License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + RN - Registered Nurse - State Licensure required Pay Range: ... fresh perspective on workplace flexibility. **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity...processes preferred. NYS RN license required… more
- Actalent (Sunrise, FL)
- …to direct utilization and capture data effectively. Responsibilities + Review prior authorization requests for medical necessity and appropriateness, utilizing ... Utilization Management Nurse !Job Description The Utilization Management Nurse ...between the Medical Director, physicians, and office staff, resolving prior authorization issues. + Communicate denial determinations… more
- Molina Healthcare (Bellevue, WA)
- …**JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse ( RN ), Licensed Vocational Nurse (LVN) ... medical clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ), Licensed Vocational Nurse … more
- CVS Health (Oklahoma City, OK)
- …Qualifications** + Experience in **utilization management** , **precertification** , or ** prior authorization ** + Background in **managed care** **Education** + ... with a requirement to **reside in Oklahoma** . The nurse in this position uses clinical expertise in a...essential. **Required Qualifications** + Active, current, and unrestricted **Oklahoma RN license** + Minimum of **3 years of clinical… more
- Staffing Solutions Organization (Augusta, ME)
- …diverse workforce, which is a reflection of our clients and the people they serve. ** Registered Nurse - Authorization Review Unit - MaineCare in Augusta, ... business rules and workflow policies; + Work with the Prior Authorization unit staff members to monitor...Ability to develop and implement corrective actions. **Minimum Qualification:** Registered Nurse and three (3) years of… more
- CVS Health (Lansing, MI)
- …the employee level **Required Qualifications** + Candidate must have active, current and unrestricted Registered Nurse ( RN ) Licensure in state of residence + ... (PREFERRED) **License** + Candidate must have active, current and unrestricted Registered Nurse ( RN ) Licensure in state of residence **Anticipated Weekly… more
- Dana-Farber Cancer Institute (Brookline, MA)
- … Prior Authorization experience is preferred. + Licensed as a Registered Nurse in the Commonwealth of Massachusetts preferred. **KNOWLEDGE, SKILLS, AND ... Specialist is responsible for the comprehensive coordination and management of all prior authorization activities specific to cellular therapy services. This… more
- Dignity Health (Rancho Cordova, CA)
- …of nursing. - BS degree or experience equivalent required. - Clear and current CA Registered Nurse ( RN ) license. - Knowledge of all applicable federal and ... and the appropriate application of policies and guidelines to Managed Care prior authorization referral requests. Under general supervision this position is… more
- Molina Healthcare (Idaho Falls, ID)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina… more
- US Tech Solutions (LA)
- **Position Summary:** As a Prior Authorization Nurse , you work outside the walls of a hospital setting in a specialty area of the nursing field providing ... utilization management prior authorization reviews. Build strong direct relationships...as indicated by staffing and business needs. **Duties:** + ** Registered Nurse with current license in LA… more
- US Tech Solutions (Wichita, KS)
- …and implementation of QM Work Plan Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in state of residence + Must have ... + MUST HAVE 6 months of Prior Authorization . **Education:** + Active and unrestricted RN ...with Utilization Review? + Do you have an Active Registered Nurse License? **About US Tech Solutions:**… more
- Banner Health (Gilbert, AZ)
- …studies through the Banner Alzheimer's Institute. Our staff takes care of the prior authorization with your insurance for your referring physician. As an ... ** RN in Outpatient Infusion Oncology** , you'll have the...care setting within the past 12 months as a Registered Nurse in the specialty area. Banner… more
- Aveanna Healthcare (Cedar Rapids, IA)
- Home Health Admissions Registered Nurse RN Full Time 15K Sign On Bonus ApplyRefer a FriendBack Job Details Requisition #: 206100 Location: Cedar Rapids, IA ... contribution to team shared on-call rotation. Position Overview TheAdmissions Registered Nurse ( RN )works next to...client start of care * Submit required documentation for prior authorization of client services as needed… more
- Premier Health (Dayton, OH)
- **Position: Registered Nurse ( RN )** **Facility: Miami Valley Hospital & Miami Valley Hospital South** **Department:** **Pain Center** **Shift: Support/ ... policy, diagnostic testing and other information by phone; and insurance prior authorization for procedures, medications, and emergent diagnostic testing.… more
- Cleveland Clinic (Beachwood, OH)
- …future caregiver include: + Graduate of an accredited school of nursing with licensure as a Registered Nurse ( RN ) in the State of Ohio + Current valid ... caregiver who excels in this role will: + Provide prior authorization support for Specialty medications specific...license in the State of Ohio as a Registered Nurse ( RN ) + Three… more
- North Shore Community Health (Peabody, MA)
- Registered Nurse Peabody, MA (http://maps.google.com/maps?q=89+Foster+Street+Peabody+MA+USA+01960) Description Primary Purpose of Position: North Shore Community ... community healthcare delivery. We have an opening for a Registered Nurse . Under the general direction of...when needed within the scope of nursing practice, including prior authorization forms . Provides health education… more
- Medtronic (MN)
- …patient access to technology by assisting physicians, hospitals, and patients with prior authorization and appeal management. This position will interface with ... Assist physicians, hospitals, and patients in understanding details of coverage polices, prior authorization , and denial management for pelvic health therapies.… more
- Atlantic Health System (Chatham, NJ)
- …care and touch base with the physicians accordingly. + Coordinate with insurance prior authorization , medication refills and other orders. + Support quality ... in nursing from an accredited program. + Licensure/Certificates: Current RN license, valid in the state of NJ +...a multispecialty physician group with more than 1,000 doctors, nurse practitioners and physician assistants at over 300 locations… more
- CVS Health (Richmond, VA)
- …to work Monday-Friday, 8 AM-5 PM, with occasional on-call duties **Preferred:** + Prior authorization experience + BSN degree + Virginia residency or compact ... heart, each and every day. **Position Summary** The Utilization Management (UM) Nurse Consultant is a remote, full-time role responsible for evaluating the medical… more
- Mayo Clinic (Rochester, MN)
- …Oncology Cancer Treatment which has 53 private spaces for medication administration. As a registered nurse ( RN ) in this collaborative role, you'll be an ... patients' lives every day. The primary role of the registered nurse ( RN ) in this...entry-level associate degree registered nurses with a RN start date prior to April 1,… more