• Payor Relations Specialist / Prior

    Select Medical (Columbus, OH)
    …Illness Recovery Hospital & Acute Inpatient Rehabilitation Hospitals **Payor Relations Specialist / Prior Authorization Specialist** **( RN , LPN )** **This ... least two (2) years of direct experience in third party reimbursement. + Must be a Registered Nurse ( RN ) or Licensed Practical Nurse (LPN). Preferred… more
    Select Medical (07/10/25)
    - Save Job - Related Jobs - Block Source
  • Payor Relations Specialist / Prior

    Select Medical (Frisco, TX)
    …with Select Medical & Baylor Scott & White Health Frisco, TX ** Prior Authorization Specialist / Payor Relations Specialist ( RN , LPN )** **Remote position ... Disabled/Veterans._ Apply for this job (https://jobs-selectmedicalcorp.icims.com/jobs/335336/payor-relations-specialist prior - authorization -specialist-%28- rn -%2c-lpn-%29/job?mode=apply&apply=yes&in\_iframe=1&hashed=1374627814) Share… more
    Select Medical (07/10/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Review Nurse - Prior

    Centene Corporation (Sacramento, CA)
    …**License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + RN - Registered Nurse - State Licensure preferred Pay Range: ... Standard Hours with occasional weekends and holidays.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service… more
    Centene Corporation (07/11/25)
    - Save Job - Related Jobs - Block Source
  • Care Review Clinician, Prior

    Molina Healthcare (Albuquerque, NM)
    …**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
    Molina Healthcare (07/04/25)
    - Save Job - Related Jobs - Block Source
  • LPN Care Review Clinician, Prior

    Molina Healthcare (Spokane, 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
    Molina Healthcare (06/27/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Nurse , Prior

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse - Prior Authorization performs medical necessity reviews ... on prior authorization requests in accordance with national standards, contractual requirements,...elective surgical cases preferred. Essential Qualifications * Current licensed Registered Nurse ( RN ) or Licensed… more
    Brighton Health Plan Solutions, LLC (06/27/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse

    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
    Staffing Solutions Organization (06/21/25)
    - Save Job - Related Jobs - Block Source
  • Associate Manager - Duals Prior

    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
    CVS Health (06/28/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Authorization Specialist

    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 (07/01/25)
    - Save Job - Related Jobs - Block Source
  • Cellular Therapy Clinical Authorization

    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
    Dana-Farber Cancer Institute (05/30/25)
    - Save Job - Related Jobs - Block Source
  • Pre- Authorization RN

    Humana (Raleigh, NC)
    …barriers to helping people achieve their best health. Humana CarePlus is seeking a Pre- Authorization Nurse who reviews prior authorization requests for ... services or forward requests to the appropriate stakeholder. The Pre- Authorization Nurse roles and responsibilities include but...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in either… more
    Humana (07/11/25)
    - Save Job - Related Jobs - Block Source
  • Pre- Authorization Nurse 2

    Humana (Madison, WI)
    **Become a part of our caring community and help us put health first** The Pre- Authorization Nurse 2 reviews prior authorization requests for appropriate ... services or forward requests to the appropriate stakeholder. The Pre- Authorization Nurse 2 work assignments are varied...RN license in the state(s) in which the nurse is required to practice + Ability to be… more
    Humana (07/08/25)
    - Save Job - Related Jobs - Block Source
  • Pre- Authorization Nurse Supervisor

    Humana (Madison, WI)
    …**Use your skills to make an impact** **Required Qualifications** + Licensed as a Registered Nurse in the State of Wisconsin, including compact license. + Two ... community and help us put health first** The UM/PA Nurse Supervisor plays a key leadership role in overseeing...Excel, and Outlook. + At least 3-years experience with prior authorization / utilization management. **Preferred Qualifications** +… more
    Humana (07/10/25)
    - Save Job - Related Jobs - Block Source
  • RN Supervisor UM Prior Auth

    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
    Dignity Health (06/20/25)
    - Save Job - Related Jobs - Block Source
  • RN - Registered Nurse (40…

    Essentia Health (Fargo, ND)
    **Job Description:** Seeking a Registered Nurse to serve in Essentia Health's pain clinic at our 32nd Avenue building in Fargo, North Dakota. This RN works 8 ... chart prep as required. 5. Authorization and Denials Support - Check prior authorization statuses related to departmental needs. - Collaborate with the … more
    Essentia Health (07/02/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse

    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 (04/18/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse

    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
    US Tech Solutions (05/09/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse 2 (Medical Care)…

    New York State Civil Service (Menands, NY)
    NY HELP Yes Agency Workers' Compensation Board Title Registered Nurse 2 (Medical Care) (NY HELPS), WCB Items #1885, 3357, and 4271 Occupational Category Health ... Zip Code 12204 Duties Description Under the direction of Registered Nurse Supervisor, SG 23, within the...2 will be responsible conducting medical necessity reviews of prior authorization requests for treatment.Specific duties include,… more
    New York State Civil Service (07/11/25)
    - Save Job - Related Jobs - Block Source
  • Home Health Admissions Registered

    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
    Aveanna Healthcare (07/04/25)
    - Save Job - Related Jobs - Block Source
  • PRN Registered Nurse ( RN

    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
    Premier Health (07/02/25)
    - Save Job - Related Jobs - Block Source