- Molina Healthcare (Los Angeles, CA)
- …stay for requested treatments and/or procedures. * Conducts reviews to determine prior authorization /financial responsibility for Molina and its members. * ... 2 years experience, including experience in hospital acute care, inpatient review, prior authorization , managed care, or equivalent combination of relevant… more
- MD Anderson Cancer Center (Houston, TX)
- …a minimum of two years of experience as an advanced practice provider. Prior experience in pain management is strongly preferred, along with demonstrated supervisory ... primary team, surgical team, and staff Anesthesiologists to ensure patient optimization prior to surgical procedure Orders and reviews labs and other ancillary tests… more
- Molina Healthcare (FL)
- …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
- Centene Corporation (Columbus, OH)
- …EXPERIENCE PEOPLE LEADER EXPERIENCE STRONGLY PREFERRED **Position Purpose:** Supervises Prior Authorization , Concurrent Review, and/or Retrospective Review ... communication between utilization management team, members, and providers + Monitors prior authorization , concurrent review, and/or retrospective clinical review… more
- GE Vernova (Wilmington, NC)
- …If applicable, final offers will be contingent on ability to obtain authorization for access to US export-controlled information from the US Government. **Desired ... methods, thermal-hydraulics, nuclear engineering, or a closely related discipline. + Prior experience with neutronic methods (eg., MCNP, PARTISN, MC2-3, DIF3D). +… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …enhance the overall operation of the department. * Guides member through the Prior Authorization and Appeals process. * Engage providers telephonically in ... opportunities for connecting members to group related benefits; eg Nurse Line, Employee Assistance Program, or other specialists with...hours. * High school diploma (or equivalency) and legal authorization to work in the US Preferred Skills and… more
- BrightSpring Health Services (Jacksonville, FL)
- …to customer requests and concerns, and coordinating the insurance verification and authorization processes + May be called upon to resolve complex customer service ... smooth transition to hospice by coordinating services and equipment needs for clients prior to their admission + Uses clinical knowledge and knowledge of hospice… more
- Billings Clinic (Billings, MT)
- …must complete several pre-employment requirements prior to starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) ... for post-acute services, and documents choices per policy * Ensures authorization is obtained for post-discharge services, if required; follows-up with facility… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …reviews of surgical and other procedures to confirm accurate perioperative pre- authorization and patient class order reconciliation process. Assesses compliance to ... regulatory and health plan requirements for authorization , including Medicare Inpatient Only List and communicates to...List and communicates to provider to obtain accurate order prior to procedure and post procedure * Ensures UR… more
- MD Anderson Cancer Center (Houston, TX)
- …(TSBPAE) as required for clinical licensure as an Advanced Practice Registered Nurse or Physician Assistant. *EXPERIENCE* Required: Two years clinical experience as ... advanced practice provider. Preferred: Acute care experience in inpatient setting. Prior Oncology experience. *LICENSURE / CERTIFICATION* Required: All of the… more