- 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
- 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 (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
- CVS Health (Tallahassee, FL)
- …4 hours a day working with providers to secure additional information for prior authorization review. This candidate will utilize clinical skills to coordinate, ... 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
- CVS Health (Tallahassee, FL)
- …telephone queue working with providers to secure additional information for prior authorization review. CVS health requires eligible colleagues identified ... **Required Qualifications** * 1 year UM, concurrent review or prior authorization * 5 years of clinical...required 100% participation during 8:30am-5pm Monday-Friday. * A Registered Nurse that must hold an unrestricted license in their… more
- Mayo Clinic (Jacksonville, FL)
- …your future. **Responsibilities** The Hyperbaric Medicine and Wound Ostomy Nurse (WON) provides expert, integrated, cost-effective quality patient care through ... patients with complex issues across the continuum of care settings. This nurse integrates knowledge of advanced pathophysiology, human responses to health problems… more
- Mayo Clinic (Jacksonville, FL)
- …package to secure your future. **Responsibilities** The Cardiovascular Device Nurse will provide thorough, competent interrogations and reprogramming of cardiac ... settings as well as remotely monitored patients. The Cardiovascular Device Nurse will complete initial interrogations, report generation, charges, and documentation… more
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