- The Arora Group (Bethesda, MD)
- Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in Bethesda, ... will be required on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW: + Initiate, perform and complete assigned duties… more
- Johns Hopkins University (Baltimore, MD)
- …discharge summaries, and scheduling follow up appointments + Completing pharmacy prior authorization forms for specialty medications + Attend cardiac ... Unit is seeking a **_Nurse Practitioner (NP)_** to join our cardiology division. The Nurse Practitioner will work collaboratively as a member of a team that provides… more
- Johns Hopkins University (Baltimore, MD)
- …of Interstitial Lung Disease (ILD) Team to care for patients with ILD. The Clinical Nurse will work under the supervision of an attending ILD physician who is a ... of new referrals to the ILD Clinic. + Facilitate and obtain insurance authorization for medical therapy, diagnostic testing and hospital admission. + Coordinate and… more
- Johns Hopkins University (Baltimore, MD)
- …appointments + Train and assist with I &R's of Prose lens + Obtain prior authorization for procedures and medications + Communicates with Registration regarding ... with prescription refill requests and specialty medication ordering. Coordinate medication prior - authorization as needed. + Determines whether patient referrals… more
- Veterans Affairs, Veterans Health Administration (District Of Columbia, DC)
- …facilities or private hospitals; performing basic eligibility, co-pays and pre- authorization requirements for specific coverage (ie, TRICARE, sharing agreements, ... of medical clinicians across multiple disciplines (eg medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical… more
- Humana (Annapolis, MD)
- …-or- compact state license. + Over 1 year of Utilization Management ( prior authorization ) experience working in managed care settings/environments (health plan). ... update training for UM nurses. + Develops programs to improve UM nurse competencies (critical thinking skills, interpreting criteria, communication with providers to… more