- CoxHealth (Springfield, MO)
- …The Navigator will work as a liaison between patients, clinic staff and the Prior Authorization Team. This role may involve occupational exposure to hazardous ... approved nursing program Experience Preferred: Minimum one (1) year experience as professional nurse within the last three (3) years. Preferred: Six (6) months home… 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 ... reviews for medical necessity and identify the need for authorization . The nurse coordinates with the healthcare...Adhere and perform timely prospective reviews for services requiring prior authorization + Follows the authorization… more
- Centene Corporation (Carson City, NV)
- …a remote position. Ideal candidate will have a Licensed Practical Nurse (LPN) or Registered Nurse ( RN ) license. Clinical license must be in the state of ... including a fresh perspective on workplace flexibility. **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service… more
- Select Medical (West Orange, NJ)
- …- West Orange** A Select Medical Hospital West Orange, NJ ** Prior Authorization Specialist/ Payor Relations Specialist ( RN , LPN )** **Full-Time** **Onsite ... and independent judgment, the Payor Relations Specialist manages the pre-certification and prior authorization of referrals scheduled for admission to the Acute… 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 ... initial, concurrent and retrospective chart reviews for clinical utilization and authorization . The Utilization Review Case Manager coordinates with the healthcare… more
- Molina Healthcare (Layton, UT)
- …**JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse ( RN ), Licensed Vocational Nurse (LVN) ... medical clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ), Licensed Vocational Nurse … more
- Molina Healthcare (Southaven, MS)
- …**JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse ( RN ), Licensed Vocational Nurse (LVN) ... medical clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ), Licensed Vocational Nurse … more
- Dana-Farber Cancer Institute (Brookline, MA)
- …environment, the Clinical Authorization Specialist will bring clinical expertise to the prior authorization and appeals processes and serve as a liaison and ... between Dana Farber Cancer Institute and various health plans. Reporting to the Prior Authorization Superv isor , the Clinical Authorization Specialist… more
- HonorHealth (AZ)
- …to become proficient. Essential Functions Perform tasks related to the management of prior authorization for patients served by infusion clinics. Reviews medical ... Job Summary Under the direction of Leadership, performs Infusion/medication authorization functions for the hospital outpatient infusion departments (or other… 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
- 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
- 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 ... presentations. Excellent verbal, written communication and presentation skills. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and… more
- Premier Health (Dayton, OH)
- **Position: Registered Nurse ( RN )** **Facility: Miami Valley Hospital & Miami Valley Hospital South** **Department:** **Pain Center** **Shift: Support/ ... policy, diagnostic testing and other information by phone; and insurance prior authorization for procedures, medications, and emergent diagnostic testing.… more
- 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
- State of Massachusetts (Boston, MA)
- The Massachusetts Mental Health Center is seeking a talented and experienced Registered Nurse to join our diverse team of mental health providers at our thriving ... or pharmacies. * Provides clinical documentation to insurers to obtain prior authorization /approval for medications/treatment as needed. * Responsible for… more
- Actalent (Virginia Beach, VA)
- …Skills & Qualifications + Graduation from an NLN Accredited School of Nursing with a Registered Nurse ( RN ) qualification. + Minimum one year experience with ... Job Title: Registered Nurse Job Description Join a...Job Title: Registered Nurse Job Description Join a dynamic team as...providers and nursing staff in the clinic. + Collect prior authorization for prescriptions and monitor task… more
- 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
- aptihealth (Clifton Park, NY)
- …and collaboration + Priding ourselves in being diverse and inclusive The Role The Registered Nurse Case Manager team at AptiHealth is pivotal to the success ... program, Bachelor's degree preferred + Currently licensed as a Registered Nurse in New York + Current...appropriate care team member + Assist prescribers with medication prior authorization , coordination with pharmacy, medication refill… more
- Mayo Clinic (Rochester, MN)
- …**This position is open to experienced nurses and new grad nurses.** The Ambulatory Care Registered Nurse ( RN ) is accountable for the delivery of direct ... 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 (Rochester, MN)
- …Oncology Cancer Treatment which has 53 private spaces for medication administration. As a registered nurse ( RN ) in this collaborative role, you'll be an ... patients' lives every day. The primary role of the registered nurse ( RN ) in this...entry-level associate degree registered nurses with a RN start date prior to April 1,… more
