- Centene Corporation (New York, NY)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of ... medical necessity of care of member + Escalates prior authorization requests to Medical ...RN license required **License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + RN - Registered… more
- Molina Healthcare (NY)
- …and its members. + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests ... benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina… more
- STG International (Plattsburgh, NY)
- …or any other protected class. Medical Corps - 60J, 60L, 61F, 61H, 61N, 61R,62B Medical Specialist Corps - 65B, 65C, 65D Nurse Corps - 66B,66H, 66P Medical ... STGi is currently seeking a Nurse Practitioner (NP) or Physician Assistant (PA) to...duties include: ESSENTIAL FUNCTIONS: + Provides primary and preventive medical care to meet the needs (physical, mental, 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 ... role facilitates the scheduling of patients for surgery, tests, referrals, medical clearance including review of pre-op medication and health history. Through… more
- Hillside Family of Agencies (Rochester, NY)
- …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 ...also be responsible for providing health care oversight and medical case management for an identified caseload of youth,… more
- Hillside Family of Agencies (NY)
- …to obtain medical /psychiatric history, establish health care needs, and complete prior authorization for medications or medical necessity based on ... NURSE SIGN ON BONUS! Job Summary The Nurse Coordinator provides health care oversight and medical... Nurse Coordinator provides health care oversight and medical case management for an identified caseload of youth/individuals.… 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… 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...room, takes appropriate vital signs and documents in electronic medical record. + Review and update medication list to… more
- Centene Corporation (New York, NY)
- …Network Provider. + Provides first level RN review for all outpatient and ancillary prior authorization requests for medical appropriateness and medical ... for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering… 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