- Teton Valley Health (Driggs, ID)
- …families and other health care organizations assuring a seamless disposition. Assures prior authorization from insurance carriers for services rendered in ... regulatory requirements, such as, DNV, OSHA, etc. The Director, as a Registered Nurse , practices in a surgical services specialty unit by providing nursing services… more
- Mayo Clinic (Jacksonville, FL)
- Job Description The registered nurse (RN) is accountable for the coordination of nursing care, including direct patient care, patient/family education and ... associate degree registered nurses with a RN start date prior to April 1, 2020 must provide documented evidence...if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization… more
- University of Iowa Hospitals & Clinics (Iowa City, IA)
- …Medical Assistant II . Under direct supervision of physician, physician assistant, nurse practitioner or registered nurse , performs technical, patient care and ... and providing information other departments. Assists in obtaining insurance prior authorizations. Percent of Time: 100% Schedule: 40 hours/week accomplished… more
- Fenway Health (Boston, MA)
- …patients including primary care and specialty visits, VNA, Infusion companies, and prior authorization for services Coordinates preventative services for defined ... patients including primary care and specialty visits, VNA, Infusion companies, and prior authorization for services Helps coordinate preventative services for… more
- The Wright Center Medical Group (Jermyn, PA)
- …with agencies such as (AHEC, Wilkes University, LCCC etc.) Assist with claims/ prior authorization issues Work with marketing to promote pharmacy services ... collaborate with a multi-disciplinary team consisting of Physicians, Residents, Nurse Practitioners, Physicians Assistants, Nurses, Licensed Clinical Social Workers… more
- Texas A&M University System (College Station, TX)
- Job Title Registered Nurse II - Prior Authorization & Referral Agency Texas A&M University Health Science Center Department University Health Services ... and team-based health care delivery. What we want The Registered Nurse II- Prior Authorization and Referral, under general supervision, manages administrative… more
- US Tech Solutions (May, OK)
- …other clinical colleagues, healthcare professionals and members. + * Follow all prior authorization procedures to guarantee an accurate process on each ... policy and procedure. + * Provide on-call after hours nurse availability for urgent PA requests. + * Provide... prior authorization . + * Train and mentor... prior authorization . + * Train and mentor representatives on the… more
- Centene Corporation (New York, NY)
- …**8:30am-5pm, Monday-Friday Eastern Standard hours.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of ... interdepartmental teams, to assess medical necessity of care of member + Escalates prior authorization requests to Medical Directors as appropriate to determine… more
- US Tech Solutions (May, OK)
- …pharmacists, other clinical colleagues, healthcare professionals and members. + Follow all prior authorization procedures to guarantee an accurate process on ... following policy and procedure. + Provide on-call after hours nurse availability for urgent PA requests. + Provide internal...each prior authorization . + Train and mentor representatives… 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...indicated by staffing and business needs. **Duties:** + **Registered Nurse with current license in LA state of employment.… more
- Staffing Solutions Organization (Augusta, ME)
- …PA reviews/dispositions based on business rules and workflow policies; + Work with the Prior Authorization unit staff members to monitor work queues and complete ... of our clients and the people they serve. **Registered Nurse - Authorization Review Unit - MaineCare...MaineCare in Augusta, ME** **Position Duties:** + Manage medical Prior Authorizations (PA) as assigned by the PA supervisor,… more
- Humana (Madison, WI)
- …specifically Word, Excel, and Outlook. + At least 3-years experience with prior authorization / utilization management. **Preferred Qualifications** + Bachelor of ... a part of our caring community and help us put health first** The UM/PA Nurse Supervisor plays a key leadership role in overseeing the daily operations of the… more
- Select Medical (Columbus, OH)
- …Recovery Hospital & Acute Inpatient Rehabilitation Hospitals **Payor Relations Specialist / Prior Authorization Specialist** **( RN , LPN )** **This position ... Payor Relations Specialist, you will manage the pre-certification and prior authorization of referrals scheduled for admission...in third party reimbursement. + Must be a Registered Nurse (RN) or Licensed Practical Nurse (LPN).… more
- LifePoint Health (Wilson, NC)
- …opportunities * * *Department/Unit Summary The LPN Testing, Scheduler, and Prior Authorization Coordinator is responsible for coordinating patient testing, ... *Licensed Practical Nurse (LPN), Pulmonary Clinic* Job Type: Full-Time, Days...setting, Gastro experience preferred . Knowledge of insurance policies, prior authorization procedures, and medical terminology. .… more
- Molina Healthcare (Albuquerque, NM)
- …benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina ... + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. +...Any of the following: Completion of an accredited Registered Nurse (RN), Licensed Vocational Nurse (LVN) or… more
- CVS Health (Lansing, MI)
- …level **Required Qualifications** + Candidate must have active, current and unrestricted Registered Nurse (RN) Licensure in state of residence + Must be able to work ... department + 3+ years clinical experience as a Registered Nurse + 3+ years of managed care experience +...+ Candidate must have active, current and unrestricted Registered Nurse (RN) Licensure in state of residence **Anticipated Weekly… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …environment, the Clinical Authorization Specialist will bring clinical expertise to the prior authorization and appeals processes and serve as a liaison and ... between Dana Farber Cancer Institute and various health plans. Reporting to the Prior Authorization Supervisor , the Clinical Authorization Specialist is… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …Specialist is responsible for the comprehensive coordination and management of all prior authorization activities specific to cellular therapy services. This ... experience required. + Case Management, Utilization Review, Oncology, Cellular Therapy and/or Prior Authorization experience is preferred. + Licensed as a… more
- Baptist Memorial (Memphis, TN)
- …strategy. Specifically the managed care techniques the Coordinator uses focuses on prior authorization for services using evidence based criteria. Areas of ... Overview Coordinator- Authorization Job Code: 22772 FLSA Status Job Family:...payer with patient access + Communicate with Utilization Review Nurse + Works assigned queues in the electronic medical… more
- Molina Healthcare (Idaho Falls, ID)
- …benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina ... its members. + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional… more
