- Humana (Atlanta, GA)
- …for an internship that supports the goal to put health first? The Prior Authorization , Registered Nurse , RN, Intern will review prior authorization requests ... variety of professional onsite, field, or remote based opportunities. The Prior Authorization , Registered Nurse , RN, Intern will utilize Humana's Medicaid… more
- Actalent (Ridgeland, MS)
- Job Title: Prior Authorization NurseJob Description The Prior Authorization Nurse plays a crucial role in analyzing authorization requests to determine ... quality and cost-effectiveness of medical care. Responsibilities + Analyze prior authorization requests to determine medical necessity and appropriate level of care.… more
- Molina Healthcare (Seattle, WA)
- …and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina Healthcare and ... + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional information from… more
- UCLA Health (Los Angeles, CA)
- …prior authorization requests for medical services. The UM Review Nurse applies clinical judgment, regulatory standards, and established guidelines to determine ... Description At UCLA Health, the Utilization Management (UM) Review Nurse plays a vital role in ensuring the delivery of high-quality, evidence-based care. This… more
- US Tech Solutions (May, OK)
- …prior authorizations following policy and procedure. + * Provide on-call after hours nurse availability for urgent PA requests. + * Provide internal nurse ... healthcare professionals and members. + * Follow all prior authorization procedures to guarantee an accurate process on each...by the PA leadership team. **Education:** **The Licensed Practical Nurse is a graduate of a school of Practical… more
- South Central Regional Medical Center (Laurel, MS)
- …Authorization Reports to: Department Manager Created: 5/1/25 Job Summary The Prior Authorization Nurse is responsible for managing the prior authorization ... Active Registered Nurse (RN) or Licensed Practical Nurse (LPN) license. + Experience in prior authorization... Nurse (LPN) license. + Experience in prior authorization , case management, or utilization review preferably in an… 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 with providers and...indicated by staffing and business needs. **Duties:** + **Registered Nurse with current license in LA state of employment.… more
- Centene Corporation (Tallahassee, FL)
- …HOME SUPPORTING MEDICARE UTILIZATION FOR OUTPATIENT, DME, HOME HEALTH AND MEDICAL PRIOR AUTHORIZATION APPROVALS.** **THE WORK SCHEDULE WILL BE MONDAY - FRIDAY 8AM - ... OR SUNDAY WITH A WEEK DAY OFF.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of… more
- US Tech Solutions (May, OK)
- …prior authorizations following policy and procedure. + Provide on-call after hours nurse availability for urgent PA requests. + Provide internal nurse ... other clinical colleagues, healthcare professionals and members. + Follow all prior authorization procedures to guarantee an accurate process on each prior … more
- State of Massachusetts (Pocasset, MA)
- …nurse under the Massachusetts Board of Registration in Nursing. Current and valid authorization to practice as a Nurse Practitioner by the Massachusetts Board ... Department of Mental Health (DMH), is seeking a dynamic, exceptional, and experienced Nurse Practitioner (NP) to serve as a psychiatric provider for patients with… more
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