- Actalent (Eugene, OR)
- Job Title: Clinical Review Nurse - Prior Authorization Job Description This role involves analyzing all prior authorization requests to determine the ... the medical necessity of care for members. + Escalate prior authorization requests to Medical Directors as... Nurse (RN) certification. + Clinical review and prior authorization experience. + 2-4 years of… more
- Actalent (Eugene, OR)
- …policies and standards. Essential Skills + Clinical review experience + Prior authorization expertise + Licensed Practical Nurse (LPN) or Registered Nurse ... Job Title: Clinical Review Nurse - Prior AuthorizationJob Description This... Prior AuthorizationJob Description This role involves analyzing prior authorization requests to assess the medical… more
- US Tech Solutions (May, OK)
- …other clinical colleagues, healthcare professionals and members. + * Follow all prior authorization procedures to guarantee an accurate process on each ... policy and procedure. + * Provide on-call after hours nurse availability for urgent PA requests. + * Provide... prior authorization . + * Train and mentor... prior authorization . + * Train and mentor representatives on the… more
- Centene Corporation (Tallahassee, FL)
- …THERE IS NO HOLIDAY OR WEEKEND SCHEDULE.** **THIS ROLE IS PART OF THE PRIOR AUTHORIZATION ESCALATION TEAM, OUTPATIENT ONLY.** **IDEALLY APPLICANTS WILL HAVE ... PRIOR AUTHORIZATION EXPERIENCE WITH STRONG COMPUTER SKILLS.**...management processes preferred. **License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required Pay Range: $26.50 -… more
- US Tech Solutions (May, OK)
- …pharmacists, other clinical colleagues, healthcare professionals and members. + Follow all prior authorization procedures to guarantee an accurate process on ... following policy and procedure. + Provide on-call after hours nurse availability for urgent PA requests. + Provide internal...each prior authorization . + Train and mentor representatives… more
- US Tech Solutions (LA)
- **Position Summary:** As a Prior Authorization Nurse , you work outside the walls of a hospital setting in a specialty area of the nursing field providing ... utilization management prior authorization reviews. Build strong direct relationships...indicated by staffing and business needs. **Duties:** + **Registered Nurse with current license in LA state of employment.… more
- Actalent (Atlanta, GA)
- …ensure the candidate has a background in utilization review nurse , or prior authorization nurse . Skills clinical review, case management, rn license, ... 100% Remote Utilization Management Nurse Description * Reviewing authorization requests...as CMS Guidelines (LCA, LCD, NCD) . Utilization Review ( Prior Authorization ) Medicare experience ( Utilization Management… more
- Humana (Frankfort, KY)
- **Become a part of our caring community and help us put health first** The Pre- Authorization Nurse 2 reviews prior authorization requests for appropriate ... and approves services or forward requests to the appropriate stakeholder. The Pre- Authorization Nurse 2 work assignments are varied and frequently require… more
- Humana (Tallahassee, FL)
- …barriers to helping people achieve their best health. Humana CarePlus is seeking a Pre- Authorization Nurse who reviews prior authorization requests for ... and approves services or forward requests to the appropriate stakeholder. The Pre- Authorization Nurse roles and responsibilities include but are not limited… 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