- Actalent (Ridgeland, MS)
- Job Title: Prior Authorization NurseJob Description The Prior Authorization Nurse plays a crucial role in analyzing authorization requests to ... the quality and cost-effectiveness of medical care. Responsibilities + Analyze prior authorization requests to determine medical necessity and appropriate… more
- Molina Healthcare (Seattle, WA)
- …benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina ... + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. +...Any of the following: Completion of an accredited Registered Nurse (RN), Licensed Vocational Nurse (LVN) or… more
- UCLA Health (Los Angeles, CA)
- …This position is responsible for reviewing and evaluating clinical documentation related to prior authorization requests for medical services. The UM Review ... efficient utilization of resources. Key Responsibilities: + Conducts clinical reviews of prior authorization requests to evaluate medical necessity and benefit… more
- Humana (Atlanta, GA)
- …Spouse looking for an internship that supports the goal to put health first? The Prior Authorization , Registered Nurse , RN, Intern will review prior ... a variety of professional onsite, field, or remote based opportunities. The Prior Authorization , Registered Nurse , RN, Intern will utilize Humana's Medicaid… more
- US Tech Solutions (May, OK)
- …other clinical colleagues, healthcare professionals and members. + * Follow all prior authorization procedures to guarantee an accurate process on each ... policy and procedure. + * Provide on-call after hours nurse availability for urgent PA requests. + * Provide... prior authorization . + * Train and mentor... prior authorization . + * Train and mentor representatives on the… more
- South Central Regional Medical Center (Laurel, MS)
- …Prior Authorization Reports to: Department Manager Created: 5/1/25 Job Summary The Prior Authorization Nurse is responsible for managing the prior ... (RN) or Licensed Practical Nurse (LPN) license. + Experience in prior authorization , case management, or utilization review preferably in an ambulatory… more
- Centene Corporation (Tallahassee, FL)
- …FROM HOME SUPPORTING MEDICARE UTILIZATION FOR OUTPATIENT, DME, HOME HEALTH AND MEDICAL PRIOR AUTHORIZATION APPROVALS.** **THE WORK SCHEDULE WILL BE MONDAY - ... SATURDAY OR SUNDAY WITH A WEEK DAY OFF.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service and… more
- US Tech Solutions (May, OK)
- …pharmacists, other clinical colleagues, healthcare professionals and members. + Follow all prior authorization procedures to guarantee an accurate process on ... following policy and procedure. + Provide on-call after hours nurse availability for urgent PA requests. + Provide internal...each prior authorization . + Train and mentor representatives… 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...indicated by staffing and business needs. **Duties:** + **Registered Nurse with current license in LA state of employment.… more
- Elevance Health (San Antonio, TX)
- …the consumer's treatment journey. **Title:** Utilization Management Representative II - Prior Authorization **Location:** Onsite at 4751 Hamilton Wolf Rd, ... Make an extraordinary impact.** The Utilization Management Representative II - Prior Authorization is responsible for managing incoming calls, including… more
Recent Jobs
-
Sales and Incentive Compensation Analyst
- Republic Services (Phoenix, AZ)
-
Supply Chain Specialist
- Leidos (Albuquerque, NM)
Related Job Searches:
Authorization,
Authorization Nurse,
Nurse,
Prior,
Prior Authorization,
Prior Authorization Nurse II,
Prior Authorization Nurse Medical,
Prior Authorization Nurse RN,
Prior Authorization Nurse Supervisor,
Prior Authorization Nurse Utilization