- US Tech Solutions (RI)
- …Fully remote ** **Duration: 12 months contract** **Job Description:** + Prior Authorization Specialist takes in-bound calls from providers, pharmacies, ... and courteous phone assistance to all callers through the criteria based prior authorization process. + Maintains complete, timely and accurate documentation… more
- Tufts Medicine (Stoneham, MA)
- …under supervision. An entry level role that typically requires little to no prior knowledge or experience, work is routine or follows standard procedures, work is ... entry level role that typically requires little to no prior knowledge or experience, work is routine or follows...valid driver's license is required for local travel to remote hospital sites, and the like. 3.Mental requirements will… more
- Sedgwick Government Solutions (Raleigh, NC)
- Job Details Care Coordinator 2025-1451 Remote (Strong Internal) Raleigh, NC, USA NPN Operations Full Time Description ** Remote Care Coordinator ** ... Coordinators focused on supporting individuals in maximizing their health and productivity? Remote Care Coordinator Responsibilities + Work from your home office… more
- BrightSpring Health Services (Scottsdale, AZ)
- …This role serves as the key point of contact for benefit investigation, prior authorization , coordination with internal stakeholders (pharmacy and nursing staff) ... and pharmacy benefits + Identifies and confirms coverage criteria, co-pays, deductibles and prior authorization requirements + Prepares and submits prior … more
- PeaceHealth (Springfield, OR)
- …departments, modalities and facilities. Facilitates equipment, third party schedules, prior authorization , physicians' schedules and staffing assignments. ... **Description** **PeaceHealth is seeking a Centralized Scheduling Coordinator - Remote (OR) for a...leadership to resolve. + Ensures cases and appointments have prior authorization ; may coordinate with PFS to… more
- Providence (OR)
- …of Outpatient Care) + Utilization Management Experience (EX. Concurrent Review, Prior Authorization , Medical Audits, Appeals or Delegation) + Experience ... them.** **Providence Health Plan is calling a Clinical Program Coordinator RN, Medicare / Medicaid who will:** + Provide...care to our members **Providence Health Plan welcomes 100% remote work to residents who reside in the following… more
- Humana (Indianapolis, IN)
- …caring community and help us put health first** The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration ... Coordinator 2 performs varied activities and moderately complex administrative/operational/customer...completing assignments. Humana Healthy Horizons in Indiana is seeking Authorization Team Members to support the Utilization Management (UM)… more
- Humana (Concord, NH)
- …to advanced) **Preferred Qualifications** + Experience with Utilization Review and/or Prior Authorization , preferably within a managed care organization + ... caring community and help us put health first** The UM Administration Coordinator contributes to administration of utilization management. The UM Administration … more
- CenterWell (Tallahassee, FL)
- …requests for services, gathering necessary information, and communicating with relevant parties. + ** Prior Authorization Support:** Assisting with the prior ... service telephone experience desired + Experience with Utilization Review and/or Prior Authorization , preferably within a managed care organization **Additional… more
- State of Massachusetts (Worcester, MA)
- …is seeking a dynamic individual to fill the role of Waiver Program Coordinator . The selected candidate is responsible for needs assessment, service plan development, ... service authorization activities, and implementation and monitoring of individualized service...as well as for MFP Demonstration participants. Waiver Program Coordinator engage in outreach as assigned to ensure that… more