- Commonwealth Care Alliance (Boston, MA)
- …Duties & Responsibilities:** + Conducts timely clinical decision review for services requiring prior authorization in a variety of clinical areas, including but ... **Required Knowledge, Skills & Abilities (must have):** + Experience with prior authorization and retrospective reviews + Proficiency reviewing clinical/medical… more
- Tidelands Health (Georgetown, SC)
- …communication skills and ability to multi-task required. **Licenses and Certifications** + Registered Nurse - South Carolina Department of Labor, Licensing and ... Tidelands and help people live better lives through better health!** **Outpatient Nurse (RN)** Are you passionate about quality and committed to excellence? Consider… more
- Universities of Wisconsin (Oshkosh, WI)
- …instruction in the Undergraduate Nursing program Specific need for a Registered Dietitian with specialty preparation in exercise physiology and sports nutrition ... MS Social Work: MSW Graduate Lecturer Positions: Minimum Education Requirements MSN Nurse Educator emphasis, Social Work, Kinesiology: PhD or other terminal degree… more
- Lucile Packard Children's Hospital (Palo Alto, CA)
- …abuse/neglect activity, and mobility. * Performs the following procedures as directed by Registered Nurse (RN)/ Nurse Practitioner (NP)/ Physician (MD) and ... specific authorization and supervision of a licensed physician or nurse . Administers medication following approved procedures and only after verification of… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …Coordinator** - **Clinical Appeals** performs prospective review (benefit advisory/ prior authorization ) admission, concurrent, and retrospective reviews ... necessity review that includes inpatient review, concurrent review, benefit advisory/ prior authorization , retrospective, out of network, and appropriateness… more
- National Youth Advocate Program (Madison, WI)
- …or Vocational Nurse (LPN/LVN) or higher health-related qualification (eg, Licensed Registered Nurse (RN) with a bachelor's degree) OR Bachelor's degree in ... scheduling initial, follow-up, wellness, and specialist appointments; preparing Treatment Authorization Requests (TARs) prior to appointments and following… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …necessity review that includes inpatient review, concurrent review, benefits advisory/ prior authorization , retrospective, out of network, and appropriateness ... or four (4) years' work experience **(Required)** + Current State Licensure as a registered nurse where licensing is required by State law **(Required)** + Three… more
- National Youth Advocate Program (Fairfax, VA)
- …processes. + Performs other duties as requested. **MINIMUM QUALIFICATIONS** + Licensed Registered Nurse (RN) with a Bachelor's or Higher health-related education ... + Assist in obtaining medical clearances from healthcare providers. + Preparing Treatment Authorization Requests (TARs) prior to appointments and following up to… more
- CVS Health (Oklahoma City, OK)
- …fast-paced environment. **Required Qualifications:** + 3+ years of clinical experience as a Registered Nurse in Med-Surg + Must have active, current and ... unrestricted Oklahoma RN licensure **Preferred Qualifications:** + Prior Authorization Experience + Utilization Management Experience + Managed Care experience… more
- Louisiana Department of State Civil Service (Kinder, LA)
- REGISTERED NURSE 1, 2, OR 3 Print...employee may be required to serve a trial detail prior to being permanently promoted + TEMPORARY JOB APPOINTMENT: This ... (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4780542) Apply REGISTERED NURSE 1, 2, OR 3 Salary...license, or DD-214 must be verified by official documentation prior to hire. + Any qualifying experience that is… more
- Louisiana Department of State Civil Service (St. Gabriel, LA)
- REGISTERED NURSE 1, 2, OR 3 Print...employee may be required to serve a trial detail prior to being permanently promoted. + TEMPORARY JOB APPOINTMENT: This ... (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4776430) Apply REGISTERED NURSE 1, 2, OR 3 Salary Depends on Qualifications Location St.… more
- Louisiana Department of State Civil Service (Angie, LA)
- REGISTERED NURSE 1, 2 or 3 (WAE)...license, or DD-214 must be verified by official documentation prior to hire. + Any qualifying experience that is based ... Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4777670) Apply REGISTERED NURSE 1, 2 or 3 (WAE) Salary $4,177.00 - $7,518.00 Monthly… more
- Molina Healthcare (MS)
- …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. +...Education** Any of the following: Completion of an accredited Registered Nurse (RN), Licensed Vocational Nurse… more
- Select Medical (West Orange, NJ)
- …for Rehabilitation - West Orange** A Select Medical Hospital West Orange, NJ ** Prior Authorization Specialist/ Payor Relations Specialist ( RN , LPN )** ... and independent judgment, the Payor Relations Specialist manages the pre-certification and prior authorization of referrals scheduled for admission to the Acute… more
- Veterans Affairs, Veterans Health Administration (Redlands, CA)
- …level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program. ... Summary The Community Care RN Clinical Coordinator is a registered professional nurse , qualified by education and experience to provide direct staff support in… more
- Molina Healthcare (Dallas, TX)
- …for a TX licensed RN with Utilization Management experience to join our Prior Authorization reviewing team. Previous UM experience with MCG/Interqual guidelines ... stay for requested treatments and/or procedures. * Conducts reviews to determine prior authorization /financial responsibility for Molina and its members. *… more
- Veterans Affairs, Veterans Health Administration (Albuquerque, NM)
- …level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program. ... Managers to join our team! Responsibilities The Community Care Case Manager is a Registered Nurse , qualified by education and experience. The Case manager will… more
- Mayo Clinic (Rochester, MN)
- …position is open to experienced nurses and new grad nurses.** The Ambulatory Care Registered Nurse (RN) is accountable for the delivery of direct patient care ... months of practice experience, hired into a scheduled FTE Registered Nurse position on the Rochester campus...of the RN start date. All entry-level associate degree registered nurses with a RN start date prior… 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
- STG International (Savannah, TN)
- THIS IS FOR A FUTURE OPENING Advanced Registered Nurse Practitioner (APRN)/ Physician Assistant (PA) STGi is currently seeking a Nurse Practitioner (NP) or ... to their need and learning capacity. + Assists the Registered Nurse to ensure all patient information...Scope of Practice/Collaborative Agreement with a state licensed physician prior to delivery of health care). + Current and… more
