- Molina Healthcare (NY)
- …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
- STG International (Plattsburgh, NY)
- STGi is currently seeking a Nurse Practitioner (NP) or Physician Assistant (PA) to provide services at our Community Based Outpatient Clinic. The general duty of the ... Nurse Practitioner (NP) or Physician Assistant (PA) is to...Scope of Practice/Collaborative Agreement with a state licensed physician prior to delivery of health care). + Current and… more
- Trinity Health (Syracuse, NY)
- …104 Union Ave ste 1005 Syracuse, NY 13203 MOC building 10th floor **Registered Nurse Scheduler** The RN Scheduler contributes to the overall success of the patient's ... to ensure cases are scheduled, coded accurately, secure insurance authorization if indicated and confirm that a safe surgical...a safe surgical plan is in place 5-7 days prior to DOS. In addition, the RN Scheduler will… more
- CDPHP (Albany, NY)
- …responsible for the clinical review and documentation for services requiring prior authorization . This includes approval determinations and appropriate ... exceptions, coordinating with Medical Directors on denials. In addition, the UR nurse is responsible for completing inpatient level of care reviews, post-acute care… more
- Hillside Family of Agencies (Rochester, NY)
- …process to obtain medical/psychiatric history, establish health care needs, and complete prior authorization for medications or medical necessity based on ... $5,000 FULL TIME REGISTERED NURSE SIGN ON BONUS! Job Summary The Nurse Manager directs the health care services staff to ensure the delivery of quality health… more
- Hillside Family of Agencies (NY)
- …pre-placements to obtain medical/psychiatric history, establish health care needs, and complete prior authorization for medications or medical necessity based on ... $5,000 FULL TIME REGISTERED NURSE SIGN ON BONUS! Job Summary The Nurse Coordinator provides health care oversight and medical case management for an identified… more
- Trinity Health (Albany, NY)
- …delivered when patients call with cardiac symptoms. Patient education via phone or nurse visits. Prescription refills, prior authorization for medicine. ... **Employment Type:** Full time **Shift:** Day Shift **Description:** ** Nurse - RNII -Cardiology Office - Phone Triage - Albany, NY - Full Time** If you are looking… more
- Centene Corporation (New York, NY)
- …Provider. + Provides first level RN review for all outpatient and ancillary prior authorization requests for medical appropriateness and medical necessity using ... a fresh perspective on workplace flexibility. **Position Purpose:** The Utilization Review Nurse I provides first level clinical review for all outpatient and… more
- Bassett Healthcare (Cooperstown, NY)
- …manner as observed by direct supervisory observation and chart documentation Obtains prior authorization for treatment/ therapy plans, and medications to ensure ... of life possible. What you'll do Under the supervision of the Oncology Nurse Supervisor, the Patient Care Coordinator LPN coordinates the referral process for… more
- Albany Medical Center (Albany, NY)
- …bed access/team approach (ICU or floor admitting MD/Pharmacy/ Nurse Manager/Clinical Nurse Specialist/Consulting MD), prior authorization , protocols for ... bed access/team approach (ICU or floor admitting MD/Pharmacy/ Nurse Manager/Clinical Nurse Specialist/Consulting MD), prior authorization , protocols for… more