- Molina Healthcare (Kenosha, WI)
- …licensure. The ideal candidate will have experience with UM and prior authorization , within both Physical Health and Behavioral Health. Candidates with a Behavioral ... and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina Healthcare and… more
- Molina Healthcare (Racine, WI)
- …and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina Healthcare and ... + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional information from… more
- Humana (Madison, WI)
- …responsibility for evolving Humana's Utilization Management of medical review by physician or nurse , with a focus on our 5+ million Medicare members. You will also ... _Access_ _:_ Ensure Humana members have fair and consistent authorization review and ability to appeal and have justification...+ _Outcomes_ : Characterize the impactable drivers of prior authorization and look at appeals rate with denials and… more
- GE Aerospace (Waukesha, WI)
- …NOTE: Military experience is equivalent to professional experience. Eligibility Requirement: + Legal authorization to work in the US is required. We will not sponsor ... drug coverage; access to a Health Coach, a 24/7 nurse -based resource; and access to the Employee Assistance Program,...offers will be contingent on the ability to obtain authorization for access to US export-controlled information from the… more
- Molina Healthcare (Green Bay, WI)
- …about this rewarding work opportunity! We are currently looking for a Registered Nurse licensed in Wisconsin to become our next IRIS Self-Directed Personal Care ... plan of care as needed + Submits for Prior Authorization for personal care services + Complies with all...license in the state of Wisconsin as a Registered Nurse . Valid Driver's License **PREFERRED EDUCATION:** Bachelor's Degree in… more
- Mayo Clinic (Eau Claire, WI)
- …which supports and complements nursing practice under the supervision of a registered nurse . The Patient Care Assistant carries out delegated skills that are within ... information from each new employee's Form I-9 to confirm work authorization . **Recruiter** Jennifer Schindeldecker **Equal opportunity** As an Affirmative Action and… more
- Mayo Clinic (Eau Claire, WI)
- …direct and indirect patient care under the supervision of the Registered Nurse (RN) and accepts delegation from care team members: physicians, advanced practice ... information from each new employee's Form I-9 to confirm work authorization . **Recruiter** Jennifer Schindeldecker **Equal opportunity** As an Affirmative Action and… more
- Mayo Clinic (La Crosse, WI)
- …in the east. Represented by a leadership team comprised of a physician, nurse , and administrator - as well as a community and employee-represented board of ... with information from each new employee's Form I-9 to confirm work authorization . **Recruiter** Kate Coleman **Equal opportunity** As an Affirmative Action and Equal… more
- Mayo Clinic (Eau Claire, WI)
- …throughout Northwest Wisconsin. Represented by a leadership team comprised of a physician, nurse , and regional chair of practice - as well as a community and ... with information from each new employee's Form I-9 to confirm work authorization . **Recruiter** Kate Coleman **Equal opportunity** As an Affirmative Action and Equal… more
- Humana (Madison, WI)
- …management (Medical Director, clinician decision making teams, quality audits, prior authorization list and clinical policy) as well as enterprise support teams ... audit. **Use your skills to make an impact** **Required Qualifications** + Registered Nurse + 2+ years + experience working with CMS Compliance Regulations +… more