• Coordinator Special Needs Waiver Populations,…

    CVS Health (Baton Rouge, LA)
    …Screening, Diagnostic, and Treatment (EPSDT) case managers, providers, and enrollees on prior authorization requests for services. The UM Coordinator will ... the scheduled appointment * Assists with problems on each prior authorization requests, including identification of new...providers and goals are being met **Required Qualifications** * Registered Nurse (Required) * Ability to facilitate… more
    CVS Health (12/19/25)
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  • Temporary to Hire Prior

    Fallon Health (Worcester, MA)
    **Overview** **This is 3 months temporary contract position for a Prior Authorization RN .** **About us:** Fallon Health is a company that cares. We ... Nurse in a clinical setting required. * 2 years' experience as a Utilization Management/ Prior Authorization nurse in a managed care payer preferred. * One… more
    Fallon Health (12/14/25)
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  • Oncology Prior Authorization Case…

    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 ... initial, concurrent and retrospective chart reviews for clinical utilization and authorization . The Utilization Review Case Manager coordinates with the healthcare… more
    University of Miami (12/20/25)
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  • Prior Authorization RN

    Humana (Indianapolis, IN)
    …part of our caring community and help us put health first** Humana is seeking a Prior Authorization RN to join the Wisconsin Medicaid Market (iCare) team. ... This position reviews the clinical appropriateness of prior authorization (PA) requests and ensures that...make an impact** **Required Qualifications** + Licensed as a Registered Nurse in the State of Wisconsin,… more
    Humana (12/18/25)
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  • 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 (10/03/25)
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  • Utilization Management Nurse Consultant,…

    CVS Health (Baton Rouge, LA)
    …all with heart, each and every day. **Position Summary** The Utilization Management Nurse Consultant (UMNC) for Prior Authorization conducts high-acuity, ... supporting regulatory compliance and organizational goals. Key Responsibilities: * Perform prior authorization clinical reviews of acute admissions using… more
    CVS Health (12/19/25)
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  • Prior Authorization Clinical Team…

    CVS Health (Baton Rouge, LA)
    …with other states and departments as needed **Required Qualifications** Active unrestricted RN licensure in Louisiana. 2 or more years clinical and managed care ... experience required Requires proficiency with computer skills which includes navigating multiple systems and keyboarding **Preferred Qualifications** Ability to mentor and support staff to meet business needs Exceptional communication skills Time efficient and… more
    CVS Health (12/19/25)
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  • 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 (10/17/25)
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  • Registered Nurse

    US Tech Solutions (Wichita, KS)
    …and implementation of QM Work Plan Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in state of residence + Must have ... + MUST HAVE 6 months of Prior Authorization . **Education:** + Active and unrestricted RN ...with Utilization Review? + Do you have an Active Registered Nurse License? **About US Tech Solutions:**… more
    US Tech Solutions (11/07/25)
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  • Registered Nurse ( RN

    LA Care Health Plan (Los Angeles, CA)
    Registered Nurse ( RN ) Manager,...Knowledge of Coordination of Care, Medicare and Medi-Cal regulations, prior authorization , level of care and length ... + Excellent verbal, written communication and presentation skills. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and… more
    LA Care Health Plan (12/09/25)
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  • RN / Registered Nurse

    University of Washington (Seattle, WA)
    …Medical Center-Northwest Heart Institute** has an outstanding opportunity for an **Intermittent Registered Nurse ( RN )** to join our **Cardiology Clinic.** ... to coordinate continuity of patient care. + Supports the prior authorization process for prescribed medications. +...patient. **REQUIREMENTS** + Active, valid Washington State or Multi-State RN license required by start date. + 2 years… more
    University of Washington (11/26/25)
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  • Registered Nurse ( RN ) | 40…

    Great River Health (West Burlington, IA)
    …with care team members to efficiently manage tasks such as referrals, prior authorization , phone calls, results notification, and medication refills. + ... & First Aid - American Heart Association within 60 Days Required + Registered Nurse Iowa Board of Nursing (IBON) (United States of America) Upon Hire Required… more
    Great River Health (12/19/25)
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  • Registered Nurse

    North Shore Community Health (Salem, MA)
    Registered Nurse Salem, MA (http://maps.google.com/maps?q=47+Congress+Street+Salem+MA+USA+01970) Description Primary Purpose of Position: North Shore Community ... community healthcare delivery. We have an opening for a Registered Nurse . Under the general direction of...when needed within the scope of nursing practice, including prior authorization forms . Provides health education… more
    North Shore Community Health (11/19/25)
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  • Registered Nurse - Non-Vascular…

    Mayo Clinic (Rochester, MN)
    …to Mayo Clinic, regardless of experience, will receive an extensive orientation program. The registered nurse ( RN ) is accountable for the coordination of ... powered by innovation and driven by purpose. As a registered nurse here, you'll be part of...entry-level associate degree registered nurses with a RN start date prior to April 1,… more
    Mayo Clinic (12/03/25)
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  • Registered Nurse - Radiology…

    Mayo Clinic (Rochester, MN)
    …to Mayo Clinic, regardless of experience, will receive an extensive orientation program. The registered nurse ( RN ) is accountable for the coordination of ... powered by innovation and driven by purpose. As a registered nurse here, you'll be part of...entry-level associate degree registered nurses with a RN start date prior to April 1,… more
    Mayo Clinic (11/08/25)
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  • Registered Nurse

    Mayo Clinic (Rochester, MN)
    …your future. **Responsibilities** Location: Mary Brigh Building, St. Marys Hospital Campus The Registered Nurse ( RN ) in the Radiology Pre/Post will use ... 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 (10/26/25)
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  • Registered Nurse - Surgical Services…

    Mayo Clinic (Rochester, MN)
    …to Mayo Clinic, regardless of experience, will receive an extensive orientation program. The registered nurse ( RN ) is accountable for the coordination of ... powered by innovation and driven by purpose. As a registered nurse here, you'll be part of...entry-level associate degree registered nurses with a RN start date prior to April 1,… more
    Mayo Clinic (10/17/25)
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  • Registered Nurse - Pain Medicine…

    Mayo Clinic (Rochester, MN)
    …Competitive retirement package to secure your future. **Responsibilities** The Pain Medicine Registered Nurse ( RN ) works with adult patients experiencing ... nurse in this dynamic practice. The registered nurse ( RN ) is accountable...entry-level associate degree registered nurses with a RN start date prior to April 1,… more
    Mayo Clinic (11/19/25)
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  • Registered Nurse - Internal Travel…

    Mayo Clinic (Rochester, MN)
    …expenses. + Retirement: Competitive retirement package to secure your future. **Responsibilities** **The registered nurse ( RN ) in the Internal Travel Team at ... be assigned to PCU or Med/Surg work units. The registered nurse ( RN ) is accountable...working in a team environment. + Computer skills required, prior experience with electronic medical record systems preferred. +… more
    Mayo Clinic (11/01/25)
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  • Registered Nurse - Intra-Operative…

    Mayo Clinic (Rochester, MN)
    …to Mayo Clinic, regardless of experience, will receive an extensive orientation program. The registered nurse ( RN ) is accountable for the coordination of ... months of practice experience, hired into a scheduled FTE Registered Nurse position on the Rochester campus...entry-level associate degree registered nurses with a RN start date prior to April 1,… more
    Mayo Clinic (12/18/25)
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