- Premera Blue Cross (Mountlake Terrace, WA)
- …+ Performs medical necessity review that includes inpatient review , concurrent review , benefits advisory/prior authorization , retrospective, out of ... Customer Service /Claims Operations, Sales and Marketing and Health Care Services to ensure consistent work processes and procedural application of clinical… more
- HealthCare Support (Houston, TX)
- …discharge as well as new requests for members who have not had recent hospitalization. Review any requests for extension of these services and if not meeting ... Utilization Review RN HealthCare Support is actively seeking a...telephonic and faxed clinical information to authorize medically necessary inpatient and outpatient care, utilizing nationally recognized evidenced based… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …+ Performs medical necessity review that includes inpatient review , concurrent review , benefit advisory/prior authorization , retrospective, out of ... . The **Care Coordinator** - **Clinical Appeals** performs prospective review (benefit advisory/ prior authorization ) admission, concurrent, and… more
- Stony Brook University (Stony Brook, NY)
- …may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR from ... a valuable member of our team, who provides clinical services to our patient population. Qualified candidates will demonstrate...of care from initial assess point. Follows cases for authorization for in patient stay. + Staff review… more
- Stony Brook University (Southampton, NY)
- …Cardiology. Excellence in clinical care and teaching in cardiology ( inpatient and outpatient). US work authorization . **PREFERRED QUALIFICATIONS:** ... and consultative cardiologist to help expand and shape cardiovascular services on the East End of Long Island. This...growth of a thriving general cardiology practice and interventional service in a region with expanding demand and rapid… more
- HCA Healthcare (Aventura, FL)
- …worth of each individual is recognized. Submit your application for the opportunity below: Inpatient Authorization Review Services SpecialistWork from ... 3% to 9% of pay (based on years of service ) + Employee Stock Purchase Plan with 10% off...benefits may vary by location._** We are seeking an Inpatient Authorization Review Services… more
- HCA Healthcare (San Antonio, TX)
- …UT, VA). Do you want to join an organization that invests in you as an Inpatient Authorization Review Services Registered Nurse or Licensed Practical ... 3% to 9% of pay (based on years of service ) + Employee Stock Purchase Plan with 10% off...make a difference. We are looking for a dedicated Inpatient Authorization Review Services… more
- HCA Healthcare (Las Vegas, NV)
- …worth of each individual is recognized. Submit your application for the opportunity below: Inpatient Authorization Review Services - Registered Nurse or ... 3% to 9% of pay (based on years of service ) + Employee Stock Purchase Plan with 10% off...benefits may vary by location._** We are seeking a Inpatient Authorization Review Services… more
- Molina Healthcare (Orlando, FL)
- …* At least 2 years experience, including experience in hospital acute care, inpatient review , prior authorization , managed care, or equivalent combination ... JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Molina Healthcare (Dallas, TX)
- …* At least 2 years experience, including experience in hospital acute care, inpatient review , prior authorization , managed care, or equivalent combination ... Excel, Teams, and One Note. Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services … more
- Actalent (Portland, OR)
- …Clinical Review Nurse will conduct medical necessity reviews for prior authorization and inpatient service requests, ensuring compliance with Medicaid ... or LPN license + Minimum 2 years of prior authorization or inpatient review experience...Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance… more
- Molina Healthcare (CA)
- …* At least 2 years experience, including experience in hospital acute care, inpatient review , prior authorization , managed care, or equivalent combination ... business hours.** JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that … more
- Molina Healthcare (San Francisco, CA)
- …least 2 years health care experience, including experience in hospital acute care, inpatient review , prior authorization , managed care, or equivalent ... hours permanently** JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that … more
- Molina Healthcare (OH)
- …* At least 2 years experience, including experience in hospital acute care, inpatient review , prior authorization , managed care, or equivalent combination ... and medical coding. JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that … more
- Molina Healthcare (WA)
- …* At least 2 years experience, including experience in hospital acute care, inpatient review , prior authorization , managed care, or equivalent combination ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Molina Healthcare (Cedar Rapids, IA)
- …least 2 years health care experience, including experience in hospital acute care, inpatient review , prior authorization , managed care, or equivalent ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Molina Healthcare (NM)
- …health Previous experience with MCG guidelines. At least 2 years of experience with inpatient concurrent review , prior authorization and managed care; Acute ... Hours .** JOB DESCRIPTION Job Summary Provides support for member clinical service review processes specific to behavioral health. Responsible for verifying… more
- Dana-Farber Cancer Institute (Boston, MA)
- …schedule: 2 weeks remote and 1 week onsite at Longwood Medical Center.** The Inpatient Authorization Specialist reports to and receives direction from the Access ... for inpatient admissions, and denial management. In addition, the Inpatient Authorization Specialist is responsible for the timely and accurate… more
- Molina Healthcare (Davenport, IA)
- …in providing physician leadership and expertise in the performance of prior authorization , inpatient concurrent review , discharge planning, case management ... policies and procedures that guide and support the provision of medical staff services . Maintains a working knowledge of applicable national, state and local laws… more
- Cedars-Sinai (Beverly Hills, CA)
- …assessing their needs, coordinating care, communicating with health plans, including concurrent review to determine the appropriateness of services rendered and ... for continued review and follow up. + Authorizes all appropriate services based upon covered benefits and necessity of care provided. + Coordinates discharge… more
