• Registered Nurse II - Prior

    Texas A&M University System (College Station, TX)
    Job Title Registered Nurse II - Prior Authorization & Referral Agency Texas A&M University Health Science Center Department University Health Services ... at ive research and team-based health care delivery. What we want The Registered Nurse II- Prior Authorization and Referral, under general supervision,… more
    Texas A&M University System (07/12/25)
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  • Payor Relations Specialist / Prior

    Select Medical (Columbus, OH)
    …Illness Recovery Hospital & Acute Inpatient Rehabilitation Hospitals **Payor Relations Specialist / Prior Authorization Specialist** **( RN , LPN )** **This ... least two (2) years of direct experience in third party reimbursement. + Must be a Registered Nurse ( RN ) or Licensed Practical Nurse (LPN). Preferred… more
    Select Medical (07/10/25)
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  • Clinical Review Nurse - Prior

    Centene Corporation (New York, NY)
    …**License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + RN - Registered Nurse - State Licensure preferred Pay Range: ... **8:30am-5pm, Monday-Friday Eastern Standard hours.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of… more
    Centene Corporation (06/18/25)
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  • Registered Nurse

    Staffing Solutions Organization (Augusta, ME)
    …diverse workforce, which is a reflection of our clients and the people they serve. ** Registered Nurse - Authorization Review Unit - MaineCare in Augusta, ... business rules and workflow policies; + Work with the Prior Authorization unit staff members to monitor...Ability to develop and implement corrective actions. **Minimum Qualification:** Registered Nurse and three (3) years of… more
    Staffing Solutions Organization (06/21/25)
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  • Associate Manager - Duals Prior

    CVS Health (Lansing, MI)
    …the employee level **Required Qualifications** + Candidate must have active, current and unrestricted Registered Nurse ( RN ) Licensure in state of residence + ... (PREFERRED) **License** + Candidate must have active, current and unrestricted Registered Nurse ( RN ) Licensure in state of residence **Anticipated Weekly… more
    CVS Health (06/28/25)
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  • Clinical Authorization Specialist

    Dana-Farber Cancer Institute (Brookline, MA)
    …environment, the Clinical Authorization Specialist will bring clinical expertise to the prior authorization and appeals processes and serve as a liaison and ... between Dana Farber Cancer Institute and various health plans. Reporting to the Prior Authorization Supervisor , the Clinical Authorization Specialist is… more
    Dana-Farber Cancer Institute (07/01/25)
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  • Cellular Therapy Clinical Authorization

    Dana-Farber Cancer Institute (Brookline, MA)
    Prior Authorization experience is preferred. + Licensed as a Registered Nurse in the Commonwealth of Massachusetts preferred. **KNOWLEDGE, SKILLS, AND ... Specialist is responsible for the comprehensive coordination and management of all prior authorization activities specific to cellular therapy services. This… more
    Dana-Farber Cancer Institute (05/30/25)
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  • Pre- Authorization Nurse Supervisor

    Humana (Madison, WI)
    …**Use your skills to make an impact** **Required Qualifications** + Licensed as a Registered Nurse in the State of Wisconsin, including compact license. + Two ... community and help us put health first** The UM/PA Nurse Supervisor plays a key leadership role in overseeing...Excel, and Outlook. + At least 3-years experience with prior authorization / utilization management. **Preferred Qualifications** +… more
    Humana (07/10/25)
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  • RN Supervisor UM Prior Auth

    Dignity Health (Rancho Cordova, CA)
    …of nursing. - BS degree or experience equivalent required. - Clear and current CA Registered Nurse ( RN ) license. - Knowledge of all applicable federal and ... and the appropriate application of policies and guidelines to Managed Care prior authorization referral requests. Under general supervision this position is… more
    Dignity Health (06/20/25)
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  • Care Review Clinician, Prior Auth…

    Molina Healthcare (Idaho Falls, ID)
    …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina… more
    Molina Healthcare (07/12/25)
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