- Fallon Health (Worcester, MA)
- …follow us on Facebook, Twitter and LinkedIn. **Brief Summary of Purpose:** The Manager, Prior Authorization RN manages all staffing and activities related to ... prior authorization which includes but is not limited to preservice,...healthcare setting preferred. **License/Certifications:** Active, unrestricted license as a Registered Nurse In Massachusetts **Experience:** + A… more
- University of Miami (Miami, FL)
- …Manager RN - Full Time The University of Miami is currently seeking a Prior Authorization Nurse Case Manager. The incumbent purose is to conduct initial ... reviews for medical necessity and identify the need for authorization . The nurse coordinates with the healthcare...Adhere and perform timely prospective reviews for services requiring prior authorization + Follows the authorization… more
- Select Medical (West Orange, NJ)
- …- West Orange** A Select Medical Hospital West Orange, NJ ** Prior Authorization Specialist/ Payor Relations Specialist ( RN , LPN )** **Full-Time** **Onsite ... and independent judgment, the Payor Relations Specialist manages the pre-certification and prior authorization of referrals scheduled for admission to the Acute… more
- University of Miami (Miami, FL)
- …CORE FUNCTIONS: + Adhere and perform timely prospective review for services requiring prior authorization as well as timely concurrent review for continuation of ... initial, concurrent and retrospective chart reviews for clinical utilization and authorization . The Utilization Review Case Manager coordinates with the healthcare… more
- Molina Healthcare (Southaven, MS)
- …**JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse ( RN ), Licensed Vocational Nurse (LVN) ... medical clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ), Licensed Vocational Nurse … more
- CVS Health (Oklahoma City, OK)
- …Qualifications** + Experience in **utilization management** , **precertification** , or ** prior authorization ** + Background in **managed care** **Education** + ... with a requirement to **reside in Oklahoma** . The nurse in this position uses clinical expertise in a...essential. **Required Qualifications** + Active, current, and unrestricted **Oklahoma RN license** + Minimum of **3 years of clinical… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …environment, the Clinical Authorization Specialist will bring clinical expertise to the prior authorization and appeals processes and serve as a liaison and ... between Dana Farber Cancer Institute and various health plans. Reporting to the Prior Authorization Supervisor , the Clinical Authorization Specialist is… more
- HonorHealth (AZ)
- …to become proficient. Essential Functions Perform tasks related to the management of prior authorization for patients served by infusion clinics. Reviews medical ... Job Summary Under the direction of Leadership, performs Infusion/medication authorization functions for the hospital outpatient infusion departments (or other… more
- Molina Healthcare (Idaho Falls, ID)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina… 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