- University of Miami (Miami, FL)
- …Review Case Manager RN - Full Time The University of Miami is currently seeking a Prior Authorization Nurse Case Manager. The incumbent purose is to conduct ... 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
- AssistRx (Orlando, FL)
- …services preferred. + Familiarity with PSP workflows including hub services, copay programs, prior authorization , and nurse support. + Strong understanding ... pharmaceutical and biotech clients. These programs may include field-based nurse support, reimbursement assistance, specialty pharmacy coordination, patient education… more
- Molina Healthcare (South Florida, FL)
- …benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina ... + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. +...Any of the following: Completion of an accredited Registered Nurse (RN), Licensed Vocational Nurse (LVN) or… 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
- Actalent (Sunrise, FL)
- …to direct utilization and capture data effectively. Responsibilities + Review prior authorization requests for medical necessity and appropriateness, utilizing ... Utilization Management Nurse !Job Description The Utilization Management Nurse ...between the Medical Director, physicians, and office staff, resolving prior authorization issues. + Communicate denial determinations… more
- CVS Health (Tallahassee, FL)
- …to 4 hours a day working with providers to secure additional information for prior authorization review. + This candidate will utilize clinical skills to ... management) experience within an **outpatient** setting, concurrent review or prior authorization . + 5 years of a...thorough, independent decisions using clinical judgement. + A Registered Nurse that must hold an unrestricted license in their… more
- Actalent (Sunrise, FL)
- …satisfaction, safety, and appropriate length of stay. Responsibilities + Review prior authorization requests for medical necessity and appropriateness using ... Actalent is hiring a Utilization Management Nurse ! Job Description The Utilization Management Nurse...with the interdisciplinary team to perform reviews of service authorization requests, ensuring the utilization of appropriate services. The… more
- WestCare Foundation (Marathon, FL)
- Registered Nurse Job Details Job Location Marathon - 3000 41st Ocean 1 - Marathon, FL Position Type Part Time Education Level 2 Year Degree Salary Range $37.45 - ... $37.45 Hourly Travel Percentage Negligible Job Category Nurse Description Position Summary: Person in this position will...medication for each client are signed and in chart prior to administering medication 100% of the time +… more
- Mayo Clinic (Jacksonville, FL)
- …Competitive retirement package to secure your future. **Responsibilities** Mayo Clinic nurse scientists conduct clinically based research to improve the health and ... at a time. To learn more visit: Overview - Mayo Clinic Research . Nurse scientists engage with Mayo Clinic physicians and scientists from a variety of disciplines… more
- Walmart (Orlando, FL)
- …adherence by addressing barriers and coordinating with prescribers, pharmacists, and prior authorization teams. + Monitor patient health status, assess ... make a meaningful impact in oncology care. As an Oncology Certified Nurse (OCN), you'll combine your clinical expertise with compassionate patient support, guiding… more