- Fallon Health (Worcester, MA)
- …equitable, high-quality, coordinated care and is continually rated among the nation's top health plans for member experience, service , and clinical quality. We ... Twitter and LinkedIn. **Brief Summary of Purpose:** The Manager, Prior Authorization RN manages all staffing and activities related...(eg, home health , DME, Infusion Therapy, Home Health Agencies, etc.) to ensure appropriate service … more
- St. Luke's University Health Network (Allentown, PA)
- …+ Submit prior authorizations for all STAT imaging orders for PCP and Specialty prior to date of service . + Submit for insurance referrals for all PG ... the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in... plan to complete site of care interview needed prior to date of service . + Perfor… more
- CVS Health (Columbus, OH)
- …data needed to perform clinical assessments and reviews as per the health plan/employer-agreed criteria within the designated service level agreements. - ... At CVS Health , we're building a world of health...position is for a Clinical Pharmacist working in the Prior Authorization team. - Collaborates with the technicians and… more
- SSM Health (St. Louis, MO)
- …and Requirements:** PRIMARY RESPONSIBILITIES + Leads and develops the infusion prior authorization processes and systems to maximize service , data ... in the future. + Resolves problems and rectifies inefficiencies related to infusion prior authorizations and denials. + Prepares service level metrics and… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …**Major/Essential Functions:** + Handle authorization process and obtain pre-certification approvals prior to service . + Submit pre-authorization requests and ... **42204BR** **Extended Job Title:** Prior Authorization Specialist **Org Level 1:** Texas Tech...pre-certifications request, approvals, and denials. + Review assigned electronic health record (EHR) Work Queue's to ensure all errors… more
- BrightSpring Health Services (Totowa, NJ)
- …relating to the proper initiation, clinical review, submission, and follow up of prior authorizations. This role requires working knowledge of pharmacy benefits and ... prior authorization process. Schedule: Monday - Friday 8:30am - 5:00pm *Competitive Pay * Health , Dental, Vision & Life Insurance *Company-Paid Short & Long-Term… more
- St. Peters Health (Helena, MT)
- The primary function of the Prior Authorization Specialist position is to provide premier customer service to the patient, physician and office staff by ... departments within the hospital to complete an accurate patient record. The Prior Authorization Specialist responsibilities may include, but are not limited to: +… more
- Stanford Health Care (Palo Alto, CA)
- …pharmacy - Manage patient scheduling for post-discharge TOC clinic -Support Medication Prior Authorization Consult Service -Projects and assignments as assigned ... have rotating shift that supports the following: -Inpatient TOC service lines, Post-discharge TOC clinic, Medication Access Program -Admission...**This is a Stanford Health Care job.** **A Brief Overview** This position assists… more
- Humana (Springfield, IL)
- …Case Manager (CCM). + Master's degree in a health or social service -related field. + Prior experience with Medicare & Medicaid recipients. + Previous ... make an impact** **Required Qualifications** + Bachelor's degree in a health or social service -related field or LPN licensure in Illinois. + Bilingual in… more
- University of Utah (Salt Lake City, UT)
- …University is a participating employer with Utah Retirement Systems ("URS"). Eligible new hires with prior URS service , may elect to enroll in URS if they make ... Details **Open Date** 08/06/2025 **Requisition Number** PRN42768B **Job Title** Prior Authorization Representative I **Working Title** Prior Authorization… more