• RN Clinical Review Nurse

    Centene Corporation (New York, NY)
    …must possess NY RN State Licensure **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service and appropriate ... interdepartmental teams, to assess medical necessity of care of member + Escalates prior authorization requests to Medical Directors as appropriate to determine… more
    Centene Corporation (05/03/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Specialist (Home-Based)…

    Sanford Health (SD)
    …for Nursing Commission for Nursing Education Accreditation (NLN CNEA). Currently holds an unencumbered registered nurse ( RN ) license with the State Board of ... relating to the implementation, ongoing evaluation, and improvements to UM and/or prior authorization processes with applicable. Completes activities relating to… more
    Sanford Health (04/30/25)
    - Save Job - Related Jobs - Block Source
  • Care Review Clinician, Prior

    Molina Healthcare (Columbus, OH)
    …**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 (04/05/25)
    - Save Job - Related Jobs - Block Source
  • Care Review Clinician, Prior

    Molina Healthcare (Long Beach, CA)
    …**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 (04/20/25)
    - Save Job - Related Jobs - Block Source
  • UM Prior Authorization Review…

    UCLA Health (Los Angeles, CA)
    …This position is responsible for reviewing and evaluating clinical documentation related to prior authorization requests for medical services. The UM Review ... efficient utilization of resources. Key Responsibilities: + Conducts clinical reviews of prior authorization requests to evaluate medical necessity and benefit… more
    UCLA Health (04/22/25)
    - Save Job - Related Jobs - Block Source
  • LPN - Prior Authorization

    Ascension Health (Wichita, KS)
    **Details** + **Department: Prior Authorization Radiology/Radiation Oncology** + **Schedule: M-F 8am-5pm** + **Clinic: Ascension Medical Group** + **Location: ... the offer._ **Responsibilities** Provide care to patients under the direction of a registered nurse or physician, functioning within scope of license. +… more
    Ascension Health (03/27/25)
    - Save Job - Related Jobs - Block Source
  • Medical Assistant and Prior

    Intermountain Health (Murray, UT)
    …discretion after training and proficiency demonstrated. This is for an MA prior authorization specialist for the Neurosciences Institute. The caregiver will ... Medical Assistant experience (verified upon hire) + Or current RN /LPN license to practice nursing in the state +...Support Certification (BLS) for healthcare providers. Must be obtained prior to start date + Demonstrated basic computer skills… more
    Intermountain Health (04/22/25)
    - Save Job - Related Jobs - Block Source
  • RN Supervisor UM Prior Auth

    Dignity Health (Rancho Cordova, CA)
    …skills. - Graduate of an accredited school of nursing. - Clear and current CA Registered Nurse ( RN ) license. **Preferred Qualifications:** - 7 years UM ... and the appropriate application of policies and guidelines to Managed Care prior authorization referral requests. Under general supervision this position is… more
    Dignity Health (04/17/25)
    - Save Job - Related Jobs - Block Source
  • RN Staff Nurse

    South Central Regional Medical Center (Laurel, MS)
    REGISTERED NURSE Position: RN Department: Prior Authorization Reports to: Department Manager Created: 5/1/25 Job Summary The Prior ... Nurse is responsible for managing the prior authorization and patient assistance processes for...drug program management. Qualifications Education and Experience + Active Registered Nurse ( RN ) or Licensed… more
    South Central Regional Medical Center (05/03/25)
    - 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
  • 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 #: 204166 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 (05/06/25)
    - 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 (04/02/25)
    - Save Job - Related Jobs - Block Source
  • Home Health Registered Nurse

    Aveanna Healthcare (West Des Moines, IA)
    Home Health Registered Nurse RN Full...client start of care * Submit required documentation for prior authorization of client services as needed ... Salary: $70,000.00 - $90,000.00 per year Position Details Position Overview TheRegistered Nurse ( RN )works next to the Clinical Manager and/or Executive Director… more
    Aveanna Healthcare (04/29/25)
    - Save Job - Related Jobs - Block Source
  • Certified Registered Nurse

    KidsPeace Childrens Hospital (Varina, IA)
    The Certified Registered Nurse Practitioner (CRNP) is responsible for overseeing the psychiatric needs of children, adolescents, and/or adults, with primary ... and maintain a valid, current and unrestricted license to practice as a Certified Registered Nurse Practitioner. Must be credentialed to serve on the Medical… more
    KidsPeace Childrens Hospital (03/22/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse , Rheumatology

    Children's Hospital Boston (Boston, MA)
    78541BRJob Posting Title: Registered Nurse , RheumatologyDepartment:Ambulatory ServicesAutoReqId:78541BRStatus:Part-TimeStandard Hours per Week:20 Job Posting ... Category:NursingJob Posting Description:The Staff Nurse will be responsible for: + Working with the...appropriate timeframe and provider for consultation. + Supporting the Prior Authorization workflow to ensure patients receive… more
    Children's Hospital Boston (04/07/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse Billings…

    Intermountain Health (Billings, MT)
    **Job Description:** The Registered Nurse ( RN ) is a professional caregiver who assumes responsibility and accountability for assessing, planning, ... mails and handles prescription refills, device orders and refills, prior insurance authorization and appeals to insurance...an accredited school of nursing is required + Current/valid Registered Nurse license from the state licensing… more
    Intermountain Health (03/26/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse , Ambulatory, FT,…

    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
    Atlantic Health System (04/22/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse - Medical Oncology…

    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
    Mayo Clinic (04/02/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse

    Mayo Clinic (Rochester, MN)
    …Mary Brigh Building, St. Marys Hospital Campus - Radiology Pediatric Imaging Center The Registered Nurse ( RN ) in the Radiology Pre/Post will use their ... of experience, will receive an extensive orientation program. The registered nurse ( RN ) is accountable...entry-level associate degree registered nurses with a RN start date prior to April 1,… more
    Mayo Clinic (04/24/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse - Pain Medicine…

    Mayo Clinic (Rochester, MN)
    …between the Pain Clinic and Inpatient Pain Service.** **Pain Clinic** The Pain Medicine Registered Nurse ( RN ) works with adult patients experiencing various ... team members is a core role of the IPS RN . The registered nurse (...entry-level associate degree registered nurses with a RN start date prior to April 1,… more
    Mayo Clinic (04/13/25)
    - Save Job - Related Jobs - Block Source