- Surgery Care Affiliates (Belleair Beach, FL)
- …of team members. + Experience with insurance regulations, clinical review, and prior authorization . + Excellent ability to conduct quality assurance audits ... inspire change. If you join our team, they will. Responsibilities The Authorization Supervisor will provide direct support for the team that verifies insurance… more
- Humana (Tallahassee, FL)
- …to helping people achieve their best health. Humana CarePlus is seeking a Pre- Authorization Nurse who reviews prior authorization requests for appropriate ... and approves services or forward requests to the appropriate stakeholder. The Pre- Authorization Nurse roles and responsibilities include but are not limited to: +… more
- Molina Healthcare (Tampa, FL)
- …benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina ... its members. + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional… more
- Evolent (Tallahassee, FL)
- …and informatics professionals who work with national health plans to ensure that prior authorization and financial coding stay accurate, compliant, and aligned ... Management plays a crucial role in supporting the comprehensive management of prior authorization and financial scope within Evolent Specialty Services.… more
- Evolent (Tallahassee, FL)
- …team, ensuring the effective and efficient management of operations related to prior authorization services for healthcare companies. This role is essential ... + Implement and manage processes that enhance efficiency and effectiveness in handling prior authorization requests. + Analyze call metrics and other performance… more
- AssistRx (Orlando, FL)
- …our proprietary systems to build, test, and maintain our library of electronic prior authorization (ePA) forms and workflows. The position also performs various ... sources, such as databases or repositories, for formulary status and prior authorization requirements for all drugs. + Test system modifications to prepare… more
- Centers Plan for Healthy Living (Margate, FL)
- …authorization requests for eligible members. PRIMARY RESPONSIBILITIES: + Assists in the prior authorization of services and ongoing authorization requests ... the care plan of the member + Coordinates with providers regarding authorization activities + Coordinates communication between authorization clinical staff,… more
- Actalent (Orlando, FL)
- …intake and processing of prior authorizations. Responsibilities include entering prior authorization requests into our system and coordinating with review ... to include review-related tasks.. Responsibilities + Accurately create and process prior authorization requests in the system. + Collaborate with… more
- Molina Healthcare (Orlando, FL)
- …family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and ... **KNOWLEDGE/SKILLS/ABILITIES** + Performs initial receipt and review of non-formulary or prior authorization requests against plan approved criteria. Requests… more
- Prime Therapeutics (Tallahassee, FL)
- …Pharmacy Technician Sr **Job Description** Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone ... staff, medical management staff and/or pharmacists. Researches, resolves and documents prior authorization outcomes in pharmacy system. + Communicates selected… more