- Trinity Health (Albany, NY)
- …electronically and send prescriptions to providers for review and submission. + Obtains prior authorization for diagnostic testing and medication and enters into ... **Employment Type:** Full time **Shift:** Day Shift **Description:** ** RN Clinical Lead - Albany Internal Medicine** If...the practice of the profession of nursing as a registered professional nurse is defined as diagnosing… more
- Dignity Health (Chandler, AZ)
- …or urgent care setting preferred Minimum of one (1) year experience in prior authorization , pre-certification, insurance benefits and how they apply to hospital ... The MA works under the direct supervision of the nurse manager in caring for the patient and providing...Association BLS Minimum of one (1) year experience in prior authorization , pre-certification, insurance benefits and how… more
- Crouse Hospital (Syracuse, NY)
- …the health care system from the initiation of the referral, to obtaining prior authorization , scheduling appointments and tracking and following up on results. ... Required Qualifications: Registered Nurse , Demonstrated experience in a multi-specialty physician office. Excellent customer service skills. Excellent computer… more
- Centene Corporation (Sacramento, CA)
- …management principles preferred. 25% Travel CA RN License Required **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... a fresh perspective on workplace flexibility. **Position Purpose:** Supervises Prior Authorization , Concurrent Review, and/or Retrospective Review Clinical… more
- US Tech Solutions (May, OK)
- …. Registered Nurse in state of residence . Must have prior authorization utilization experience . Able to work in multiple IT platforms/systems Skills: ... MANAGEMENT EXP, pref. knowledge of Milliman/MCG. . MUST HAVE 6 months of Prior Authorization . Education: . Active and unrestricted RN licensure in state of… more
- University of Colorado (Denver, CO)
- …Assistant II level:** + Process basic referrals and imaging study orders. + Process prior authorization requests. + Train and onboard newly hired MAs. + ... **Supervision Received:** Direct supervision will be provided by an RN for Case Management, an APN Clinical Lead, or...substitute for completion of an accredited medical assistant program.** ** Registered Nurse / Bachelor of Medicine, Bachelor… more
- Stony Brook University (Stony Brook, NY)
- …with the transferring hospital, Patient Access and physicians and payers for authorization prior to transfer from other hospitals. + Consistent documentation ... of care from initial assess point. Follows cases for authorization for in patient stay. + Staff review short...required. **Qualifications** **Required** : A Bachelor's degree or a nurse working on their degree with an RN… more
- Molina Healthcare (Louisville, KY)
- … RN license. The Care Review Clinician Inpatient Review BH will provide prior authorization for outpatient and inpatient services for the OH Medicaid ... of stay for requested treatments and/or procedures. * Conducts reviews to determine prior authorization / financial responsibility for Molina and its members. *… more
- The County of Los Angeles (Los Angeles, CA)
- …work at the direction of a rehabilitation therapist, social worker, or registered nurse . Incumbents are typically responsible for providing technical direction ... Psychiatrists in completing and checking for accuracy on Treatment Authorization Request (TAR) and Prior Authorization (PA) forms. + Promptly responds to… more
- Saint Luke's (Lees Summit, MO)
- …+ **Responsibilities include: managing designated aspects of care coordination, prior authorization , clinical documentation, and concurrent review programs ... experience, 2+ years of leadership experience and either an RN license, LCSW or MSW to be considered!** +...to: * Managing designated aspects of the case coordination, prior authorization , clinical documentation, and concurrent review… more