- Actalent (Eugene, OR)
- Job Title: Clinical Review Nurse - Prior Authorization Job... (LPN) or Registered Nurse ( RN ) certification. + Clinical review and prior ... Description This role involves analyzing all prior authorization requests to determine the medical necessity of services...the medical necessity of care for members. + Escalate prior authorization requests to Medical Directors as… more
- Actalent (Eugene, OR)
- …+ Clinical review experience + Prior authorization expertise + Licensed Practical Nurse (LPN) or Registered Nurse ( RN ) certification + 2-4 years ... Job Title: Clinical Review Nurse - Prior AuthorizationJob Description This... Prior AuthorizationJob Description This role involves analyzing prior authorization requests to assess the medical… more
- Molina Healthcare (Spokane, WA)
- …**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
- 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
- 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 ... services or forward requests to the appropriate stakeholder. The Pre- Authorization Nurse 2 work assignments are varied...Qualifications - What it takes to Succeed** + Licensed Registered Nurse ( RN ) in the… 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 ... services or forward requests to the appropriate stakeholder. The Pre- Authorization Nurse roles and responsibilities include but...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in either… more
- Mille Lacs Health System (Onamia, MN)
- …the direction of the Health Information Supervisor/Director of Revenue Cycle. The Prior Authorization Coordinator (PAC) is responsible for ensuring that payers ... with insurance companies within the electronic medical record. + Document all prior authorization information including approval dates, billing units, procedure… more
- Dignity Health (Rancho Cordova, CA)
- …of nursing. - BS degree or experience equivalent required. - Clear and current CA Registered Nurse ( RN ) license. - Knowledge of all applicable federal and ... and the appropriate application of policies and guidelines to Managed Care prior authorization referral requests. Under general supervision this position is… 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