- CVS Health (Raleigh, NC)
- …all with heart, each and every day. **Position Summary** Medicare Precertification Utilization Management Nurse Consultant position: _Utilization Management is ... management function. **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN licensure in state of… more
- CVS Health (Harrisburg, PA)
- …Medicare Behavioral Health Outpatient clinician will be part of the Medicare precertification team. Members of this team will utilize their clinical experience to ... state of residence (LMSW, LCSW, LISW, LPC, or comparable) OR Registered Nurse licensure with psychiatric specialty, certification, or experience in state of… more
- US Tech Solutions (Canton, MA)
- …required.** **Job Summary The Clinical Reviewer is a licensed professional -a Registered Nurse preferred- that is expected to function independently in her / his ... / Outpatient UM team and works under the general direction of the Precertification Team Manager or department Manager. The Clinical Reviewer is expected to… more
- Veterans Affairs, Veterans Health Administration (San Francisco, CA)
- Summary The Revenue Utilization Review (RUR) nurse is under the supervision of the Nurse Manager and ANM. The RUR nurse is an active member of the revenue ... within the scope of the CPAC for revenue reimbursement. The RUR nurse applies advanced clinical knowledge, communication skills, and collaboration to promote… more
- WestCare Foundation (Marathon, FL)
- Registered Nurse Job Details Job Location Marathon - 3000 41st Ocean 1 - Marathon, FL Education Level 2 Year Degree Salary Range $37.45 - $37.45 Hourly Travel ... Percentage Negligible Job Category Nurse Description Provides professional nursing care to clients who...clinic. Example Job Duties: + Determines need for insurance precertification upon admission and implements process in accordance with… more
- Katmai (Fort Carson, CO)
- …for those enrollees identified as having the need for inpatient/outpatient precertification . **ESSENTIAL DUTIES & RESPONSIBILITIES** + Review precertification ... Registered Nurses (RN) licensed in Colorado, be able to practice using a nurse compact state license or have a license from any United States jurisdiction… more
- Weill Cornell Medical College (New York, NY)
- Title: Nurse Practitioner (FNP) - Neurosurgery Chiari CARE Location: Upper East Side Org Unit: Neurological Surgery Work Days: Monday-Friday Exemption Status: Exempt ... Parkinson's disease and other movement disorders. We are currently seeking a Family Nurse Practitioner (FNP) for the Chiari CARE Program. In collaboration with an… more
- Weill Cornell Medical College (New York, NY)
- Title: Registered Nurse Location: Upper East Side Org Unit: GI Oncology Clinical Admin Operations Work Days: Monday-Friday Weekly Hours: 35.00 Exemption Status: ... policies and procedures. + May be responsible for the precertification and preauthorization of prescriptions. + When needed, records...more years of related work experience as a Registered Nurse . Extensive experience as a Registered Nurse … more
- Weill Cornell Medical College (New York, NY)
- Title: Registered Nurse Location: Upper East Side Org Unit: Nursing and Technicians Work Days: Weekly Hours: 35.00 Exemption Status: Exempt Salary Range: $108,000.00 ... policies and procedures. + May be responsible for the precertification and preauthorization of prescriptions. + When needed, records...more years of related work experience as a Registered Nurse . Extensive experience as a Registered Nurse … more
- Bon Secours Mercy Health (Lorain, OH)
- …excellence. **Primary Function/General Purpose of Position** The Admissions Coordinator Registered Nurse (RN) is responsible for the coordination of all Acute ... worker, care coordinators, therapists, and nursing. Collaborates with PM&R physician, and nurse manager on all acute rehab referrals to establish eligibility for… more
- Weill Cornell Medical College (New York, NY)
- Title: Registered Nurse - Casual Location: Upper East Side Org Unit: Myeloma Clinical Admin Operations Work Days: Monday-Friday Weekly Hours: 14.00 Exemption Status: ... policies and procedures. + May be responsible for the precertification and preauthorization of prescriptions. + When needed, records...more years of related work experience as a Registered Nurse . Extensive experience as a Registered Nurse … more
- Ascension Health (Jacksonville, FL)
- …departmental staff with issues related to coding, medical records/documentation, precertification , reimbursement and claim denials/appeals. + Assess and coordinate ... **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse obtained prior to hire date or job transfer...date or job transfer date. Licensed as a Registered Nurse in Florida. Credentialed from State Board of Nursing… more
- LifePoint Health (Athens, TN)
- …* Verifies insurance benefits and obtains precertification /authorizationas necessary.Determinesand accepts required payments, including co-pays ... □ Preferred X Required Required Licenses[Tennessee, United States] Nursing Assistant Certified Nurse Aide Licensure in State of TNX Preferred □ Required Required… more
- CVS Health (Phoenix, AZ)
- …healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. **Key Responsibilities** + Apply critical thinking ... and Substance Abuse to evaluate inpatient and outpatient services requiring precertification . + Conduct clinical reviews via phone and electronic documentation,… more
- CVS Health (Austin, TX)
- …it all with heart, each and every day. **Position Summary** Medicare precertification position (weekends) + Utilizes clinical experience and skills in a ... all metrics._** **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN licensure in state of… more
- Ascension Health (Wichita, KS)
- …departmental staff with issues related to coding, medical records/documentation, precertification , reimbursement and claim denials/appeals. + Assess and coordinate ... **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse credentialed from the Kansas Board of Nursing required. Education:… more
- Ascension Health (Tulsa, OK)
- …departmental staff with issues related to coding, medical records/documentation, precertification , reimbursement and claim denials/appeals. + Assess and coordinate ... and regulations. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Oklahoma Board of Nursing obtained prior to… more
- Ascension Health (Baltimore, MD)
- …departmental staff with issues related to coding, medical records/documentation, precertification , reimbursement and claim denials/appeals. + Assess and coordinate ... and regulations. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Maryland Board of Nursing obtained prior to… more
- Weill Cornell Medical College (New York, NY)
- Title: Registered Nurse -Triage Location: Upper East Side Org Unit: Clinical Operations Work Days: Monday-Friday Weekly Hours: 35.00 Exemption Status: Exempt Salary ... protocol requirements, if applicable. + May be responsible for the precertification and preauthorization of prescriptions and for routing pended prescription refill… more
- Weill Cornell Medical College (New York, NY)
- Title: Registered Nurse -Triage (Pediatrics) Location: West Side Org Unit: Clinical Operations Work Days: Weekly Hours: 35.00 Exemption Status: Exempt Salary Range: ... protocol requirements, if applicable. + May be responsible for the precertification and preauthorization of prescriptions and for routing pended prescription refill… more
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