- University of Miami (Miami, FL)
- … Manager RN - Full Time The University of Miami is currently seeking a Prior Authorization Nurse Case Manager . The incumbent purose is to conduct initial ... + Adhere and perform timely prospective reviews for services requiring prior authorization + Follows the authorization process using established criteria… more
- University of Miami (Miami, FL)
- …CORE FUNCTIONS: + Adhere and perform timely prospective review for services requiring prior authorization as well as timely concurrent review for continuation of ... conducts initial, concurrent and retrospective chart reviews for clinical utilization and authorization . The Utilization Review Case Manager coordinates with the… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …coverage denials cannot be overturned. + Appropriately escalates complex cases to Drug Authorization Supervisor or Manager of Prior Authorizations. + ... Clinical Authorization Specialist will bring clinical expertise to the prior authorization and appeals processes and serve as a liaison and patient advocate… more
- Carle Health (Urbana, IL)
- Overview Manages the daily activities of Patient Access Medical Insurance and Prior Authorization departments to ensure high quality customer service and improve ... policies consistently + Manages daily activities of the Medical Insurance and Prior Authorization departments + Ensure quality and quantity of work… more
- Fallon Health (Worcester, MA)
- …expectations. The FH Authorization Coordinator serves to administer the FH prior authorization process as outlined in the Plan Member Handbook/Evidence of ... + Keeps records and submits reports assigned by the Manager + Refers to high-risk cases to the Case...a primary trainer for all UM Nurses on the prior authorization assignment, for new hires and… more
- Fallon Health (Worcester, MA)
- …expectations. The FH Authorization Coordinator serves to administer the FH prior authorization process as outlined in the Plan Member Handbook/Evidence of ... when the authorization meets the criteria listed in the appropriate Prior Authorization Protocol, authorizations not meeting protocol parameters are prepared… more
- University of Rochester (Rochester, NY)
- …data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical ... follow up. Adheres to approved protocols for working referrals and prior authorizations. **ESSENTIAL FUNCTIONS** + Responsible for managing department referrals.… more
- Bassett Healthcare (Cooperstown, NY)
- …or manager + Maintains 100% attendance to all divisional or staff meetings unless prior authorization of the Manager or Director What we need from you ... possible. What you'll do Under the direction of the Manager of Security Operations and the Network Director of...Refuses to admit persons who cannot show either proper authorization or cause for being admitted. Provides information and… more
- Bassett Healthcare (Cooperstown, NY)
- …or manager + Maintains 100% attendance to all divisional or staff meetings unless prior authorization of the Manager or Director What we need from you ... the direction of the Network Director of Security and Transportation or the Manager of Security Operations, the Security Officer II performs a variety of security… more
- University of Rochester (Rochester, NY)
- …Management, Social Work, Patient Accounts, Medical Records, Home Care Coordinators, Prior Authorization Teams, Contracting and Finance. + Coordinate with ... PURPOSE The individual in this position is responsible for assisting the manager and providing direct supervision of assigned team(s) with daily operations. Ensure… more
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