- Actalent (Rancho Cordova, CA)
- Prior Authorization RN FULLY...and accessible healthcare to all Californians! Job Description The Prior Authorization Nurse will triage ... and review cases as necessary, handling prior authorization cases in accordance with medical policy and utilizing available resources. The role involves… more
- Centene Corporation (New York, NY)
- …**License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + RN - Registered Nurse - State Licensure preferred Pay Range: ... have an active New York State nursing license.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service and… more
- UCLA Health (Los Angeles, CA)
- …This position is responsible for reviewing and evaluating clinical documentation related to prior authorization requests for medical services. The UM Review ... efficient utilization of resources. Key Responsibilities: + Conducts clinical reviews of prior authorization requests to evaluate medical necessity and benefit… 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...as indicated by staffing and business needs. **Duties:** + ** Registered Nurse with current license in LA… more
- Commonwealth Care Alliance (Boston, MA)
- …Duties & Responsibilities:** + Conducts timely clinical decision review for services requiring prior authorization in a variety of clinical areas, including but ... **Required Knowledge, Skills & Abilities (must have):** + Experience with prior authorization and retrospective reviews + Proficiency reviewing clinical/medical… more
- US Tech Solutions (Wichita, KS)
- …and implementation of QM Work Plan Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in state of residence + Must have ... + MUST HAVE 6 months of Prior Authorization . **Education:** + Active and unrestricted RN ...with Utilization Review? + Do you have an Active Registered Nurse License? **About US Tech Solutions:**… more
- Banner Health (Gilbert, AZ)
- …studies through the Banner Alzheimer's Institute. Our staff takes care of the prior authorization with your insurance for your referring physician. As an ... ** RN in Outpatient Infusion Oncology** , you'll have the...care setting within the past 12 months as a Registered Nurse in the specialty area. Banner… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse ( RN ) Manager,...Knowledge of Coordination of Care, Medicare and Medi-Cal regulations, prior authorization , level of care and length ... + Excellent verbal, written communication and presentation skills. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and… more
- University of Washington (Seattle, WA)
- …Medical Center-Northwest Heart Institute** has an outstanding opportunity for an **Intermittent Registered Nurse ( RN )** to join our **Cardiology Clinic.** ... to coordinate continuity of patient care. + Supports the prior authorization process for prescribed medications. +...patient. **REQUIREMENTS** + Active, valid Washington State or Multi-State RN license required by start date. + 2 years… more
- Great River Health (West Burlington, IA)
- …with care team members to efficiently manage tasks such as referrals, prior authorization , phone calls, results notification, and medication refills. + ... & First Aid - American Heart Association within 60 Days Required + Registered Nurse Iowa Board of Nursing (IBON) (United States of America) Upon Hire Required… more