- 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
- Hunterdon Health Care System (Flemington, NJ)
- …conducted through the application of evidence-based criteria or guidelines, and through authorization / prior authorization under the provisions of an ... Degree in nursing OR if Associates Degree or Diploma, RN must provide proof of enrollment in a BSN...must provide proof of enrollment in a BSN program prior to hire, be continuously enrolled and complete within… more
- Centene Corporation (New York, NY)
- …Provides first level RN review for all outpatient and ancillary prior authorization requests for medical appropriateness and medical necessity using ... NYS Driver's License or Identification card.** **Position Purpose:** The Utilization Review Nurse I provides first level clinical review for all outpatient and… more
- Bear Mountain Health Care (Lowell, MA)
- …within scope of practice + Responsible for completing medication interchange and insurance prior to authorization as assigned + Ordering or arranging for ... Bear Mountain Healthcare has immediate openings for Registered Nurses looking to work in our Long...competency. Initiate the SBAR process and collaborate with the RN for assessment and recommendations. Documents the resident's condition… more
- KidsPeace Childrens Hospital (Schnecksville, PA)
- …as necessary collaboration/supervision agreements with Advance Practice Professionals (Certified Registered Nurse Practitioners or Physician Assistants) and ... of standards, insurance company appeals and teleconferences and provision of prior authorization information; e. Participating in the development,… more
- Healthfirst (NY)
- …oversight and operational management for all utilization management functions, including prior authorization , concurrent review, and service requests Lead, ... coach, and develop UM managers overseeing interdisciplinary teams of registered nurses, social workers, clinicians, and coordinators Ensure UM operations meet… more
- US Tech Solutions (RI)
- …UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. + MUST HAVE 6 months of Prior Authorization . **Education:** + RN with current unrestricted state ... experience required. + Must have experience with Medcompass + Must have prior authorization utilization experience. + Managed Care/Medicare experience preferred.… more
- Guthrie (Binghamton, NY)
- …safe and timely dispensing of the medication for the patient as needed. Medication Prior Authorization + Collect necessary documentation and submit it to the ... needed for patient that have arrived without orders. Prepare educational materials for the RN Nurse Navigator for Chemo Education Visits per the instruction and… more
- CDPHP (Latham, NY)
- …invites you to be a part of that experience. The Medicaid Special Programs Registered Nurse Case Manager is responsible and accountable for coordinating the care ... and cost outcomes. In addition, the Medicaid Special Programs Registered Nurse Case Manager is responsible and...Manager is responsible and accountable for coordinating requests for prior authorization received via the telephone line,… more