- Genmab (Berkeley Heights, NJ)
- …not limited to Medicare, Medicaid and commercial insurance carriers, Prior Authorization submissions/appealsUnderstanding of the healthcare industry, including ... provide a positive experience. This position reports to the Patient Services Manager , Call Center Operations.The creation of our new internal Genmab Patient Services… more
- Monster (Quincy, MA)
- …the overall implementation of the CMS Advancing Interoperability and Improving Prior Authorization Processes Final Rule across MassHealth. The Interoperability ... JOB TITLE: Project Manager JOB LOCATION: Quincy MA WAGE RANGE*: $70-$72...limited to:January 1, 2026: Ensure that MassHealth adjudicates urgent Prior Authorization (PA) requests within 3 days,… more
- Monster (Salinas, CA)
- Monterey County Health Department Salinas, CA 93906 Behavioral Health Services Manager II Salary: $10,993.00 - $15,006.00 Monthly Final Filing Date: September 28, ... Behavioral Health Bureau (MCBH) has openings for multiple full-time Behavioral Health Services Manager IIs (BHSM II). The Bureau currently has vacancies in Access to… more
- Monster (Albany, NY)
- …epicenter of high-tech innovation and commercialization. Job Description: Job Summary The Manager of Travel Services is responsible for leading the travel services ... technical data, technology, software, or restricted programs where US Government authorization may be required. For positions requiring such access, offers of… more
- Monster (Marina, CA)
- …value when Variance Purchase Orders (VPOs) are required, along with obtaining authorization for reporting manager for any indirect construction expenses required ... POSITION SUMMARY: The Construction Manager coordinates all on-site construction activities, maintains the job site office, closes out projects, and supervises all… more
- Inside Higher Ed (Riverside, CA)
- …Please connect with them directly using this link prior to completing the application: https://careers-anothersource.icims.com/jobs/102146/accounting- manager ... uc-riverside/job.Under the minimal direction of the Assistant Controller, the Accounting Manager is responsible for the overall management of Treasury and General… more
- Monster (Alhambra, CA)
- …coordinating of the day-to day activities in the medical group, request for authorization for ancillary services, and certify the group is utilizing the most cost ... to: Case management following Policy and Procedures (P&P) Assure authorization is on file for all services approved by...file for all services approved by the delegated entity prior to claims payment Notify the CM nurse if… more
- Monster (Hockessin, DE)
- …early mornings depending on events Candidates must have unrestricted work authorization in the US Benefits include medical/dental/vision insurance, 401(k) with up ... Application Review Video screen with HR and the Hiring Manager Final In-Person Interview with Hiring Manager ...15th. We recommend that interested applicants submit their applications prior to this date. Mt. Cuba is targeting a… more
- Monster (Wasilla, AK)
- …the leadership team in the development and implementation of policies; in the authorization of outside medical services; and as a subject matter expert regarding ... time of interview, at the discretion of the hiring manager . SPECIAL INSTRUCTIONS FOR FOREIGN EDUCATION Education completed in...valid driver's license. Proof of licensure will be required prior to reporting to duty. For more information on… more
- Monster (Northbrook, IL)
- …and resolution of gaps in the business processes. Involved in security/ authorization set-up, user documentation, data interface design, data migration and ... have been thoroughly researched and compared against the team's knowledge database prior to escalation. Utilize knowledge database and call tracking database to… more
- University of Miami (Miami, FL)
- … Manager RN - Full Time The University of Miami is currently seeking a Prior Authorization Nurse Case Manager . The incumbent purose is to conduct initial ... + Adhere and perform timely prospective reviews for services requiring prior authorization + Follows the authorization process using established criteria… more
- University of Miami (Miami, FL)
- …CORE FUNCTIONS: + Adhere and perform timely prospective review for services requiring prior authorization as well as timely concurrent review for continuation of ... conducts initial, concurrent and retrospective chart reviews for clinical utilization and authorization . The Utilization Review Case Manager coordinates with the… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …coverage denials cannot be overturned. + Appropriately escalates complex cases to Drug Authorization Supervisor or Manager of Prior Authorizations. + ... Clinical Authorization Specialist will bring clinical expertise to the prior authorization and appeals processes and serve as a liaison and patient advocate… more
- Carle Health (Urbana, IL)
- Overview Manages the daily activities of Patient Access Medical Insurance and Prior Authorization departments to ensure high quality customer service and improve ... policies consistently + Manages daily activities of the Medical Insurance and Prior Authorization departments + Ensure quality and quantity of work… more
- University of Rochester (Rochester, NY)
- …data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical ... follow up. Adheres to approved protocols for working referrals and prior authorizations. **ESSENTIAL FUNCTIONS** + Responsible for managing department referrals.… more
- Bassett Healthcare (Cooperstown, NY)
- …or manager + Maintains 100% attendance to all divisional or staff meetings unless prior authorization of the Manager or Director What we need from you ... possible. What you'll do Under the direction of the Manager of Security Operations and the Network Director of...Refuses to admit persons who cannot show either proper authorization or cause for being admitted. Provides information and… more
- Bassett Healthcare (Cooperstown, NY)
- …or manager + Maintains 100% attendance to all divisional or staff meetings unless prior authorization of the Manager or Director What we need from you ... the direction of the Network Director of Security and Transportation or the Manager of Security Operations, the Security Officer II performs a variety of security… more
- University of Rochester (Rochester, NY)
- …Management, Social Work, Patient Accounts, Medical Records, Home Care Coordinators, Prior Authorization Teams, Contracting and Finance. + Coordinate with ... PURPOSE The individual in this position is responsible for assisting the manager and providing direct supervision of assigned team(s) with daily operations. Ensure… more
- Omaha Children's Hospital (Omaha, NE)
- …Functions** + Authorization Coordination + Verify insurance coverage and obtain prior authorizations for a range of scheduled outpatient services. + Ensure the ... and make a difference where it matters most. **A Brief Overview** The Authorization Specialist plays a critical role in ensuring patients receive timely and… more
- LA Care Health Plan (Los Angeles, CA)
- …Preferred: Experience in Medi-Cal managed care. 1 year of experience in UM/ Prior Authorization . Skills Required: Demonstrated proficiency in Medical Terminology ... Authorization Technician II Job Category: Clinical Department: Utilization...required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in… more
