- Molina Healthcare (Omaha, NE)
- …and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina Healthcare ... members. + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional information… more
- Ascension Health (Elk Grove Village, IL)
- …required. + Experience: At least 1-2 years of cardiology experience preferred. Prior experience in heart failure, LVAD, or transplant strongly preferred. + Skills: ... + BLS Provider credentialed from the American Heart Association (AHA) obtained prior to hire date or job transfer date required. Credentials are verified… more
- Centene Corporation (San Antonio, TX)
- …of Texas via the Texas BHEC as an LPC, LCSW, or LMFT. Registered Nurse must have direct psychiatric/mental health work experience and hold Texas State Licensure ... of care and services are medically appropriate + Performs prior authorization reviews related to mental health and substance...and Family Therapist required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required… more
- Centene Corporation (Raleigh, NC)
- …to ensure level of care and services are medically appropriate + Performs prior authorization reviews related to mental health and substance abuse to determine ... HEALTH ALL STATES AND DELAWARE MEDICAID INPATIENT AND PHP PRIOR AUTHORIZATIONS.** **Education/Experience:** Requires Graduate of an Accredited School Nursing… more
- Ascension Health (Broadview, IL)
- …+ BLS Provider credentialed from the American Heart Association (AHA) obtained prior to hire date or job transfer date required. Credentials are verified ... by local staff credentialing office + Nurse Practitioner credentialed from the Illinois Department of Financial...the Illinois Department of Financial and Professional Regulation obtained prior to hire date or job transfer date required.… more
- Molina Healthcare (San Jose, CA)
- California residents preferred.** **EMERGENCY ROOM ADMISSIONS REVIEW NURSE ** **_3-12 DAY SHIFT 7:30AM - 08:30PM PACIFIC HOURS NON EXEMPT, 3 days a week will ... for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed. +...Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge… more
- Centene Corporation (Tallahassee, FL)
- …(BH) and/or autism spectrum disorder needs and clinical standards + Performs prior authorization reviews related to BH to determine medical appropriateness in ... or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required or + Board Certified… more
- Eastern Connecticut Health Network (Manchester, CT)
- …to the Manager of Behavioral Health Crisis and takes direction from the Clinical Nurse Manager of the department where they are floated. Provides direct and indirect ... certification within 6 months of hire into the role. EXPERIENCE: + Prior experience working in the Behavioral Health field, preferably to specific prospective… more
- Edwards Lifesciences (Sacramento, CA)
- …direct patient care in cardiac critical care or a cath lab, eg, Registered Nurse , CST, PA, MD or Practitioner. * Proven successful project management skills * Strong ... successful candidate will depend on various factors (eg, qualifications, education, prior experience). Applications will be accepted while this position is posted… more
- Prime Healthcare (Lynwood, CA)
- …EDUCATION, EXPERIENCE, TRAINING 1. Must have current valid license as a Registered Nurse , LPT, PST, MFT, or LCSW issued by the State.2. LPS certification preferred ... or needs to obtain this prior to commencement of employment.3. Current BCLS (AHA) certificate upon hire and maintain current.4. Minimum two (3) years experience in… more