- Actalent (Ridgeland, MS)
- …of utilization management processes. Additional Skills & Qualifications + Registered Nurse ( RN ) preferred. + Prior experience with clinical review ... Job Title: Prior Authorization NurseJob Description The Prior Authorization Nurse plays a crucial role in analyzing authorization requests to… more
- Centene Corporation (New York, NY)
- …must possess NY RN State Licensure **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service and appropriate ... interdepartmental teams, to assess medical necessity of care of member + Escalates prior authorization requests to Medical Directors as appropriate to determine… more
- Sanford Health (SD)
- …for Nursing Commission for Nursing Education Accreditation (NLN CNEA). Currently holds an unencumbered registered nurse ( RN ) license with the State Board of ... relating to the implementation, ongoing evaluation, and improvements to UM and/or prior authorization processes with applicable. Completes activities relating to… more
- Molina Healthcare (Las Cruces, NM)
- …**JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse ( RN ), Licensed Vocational Nurse (LVN) ... medical clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ), Licensed Vocational Nurse … more
- Molina Healthcare (Seattle, WA)
- …**JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse ( RN ), Licensed Vocational Nurse (LVN) ... medical clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ), Licensed Vocational Nurse … 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
- Ascension Health (Wichita, KS)
- **Details** + **Department: Prior Authorization Radiology/Radiation Oncology** + **Schedule: M-F 8am-5pm** + **Clinic: Ascension Medical Group** + **Location: ... the offer._ **Responsibilities** Provide care to patients under the direction of a registered nurse or physician, functioning within scope of license. +… more
- Intermountain Health (Murray, UT)
- …discretion after training and proficiency demonstrated. This is for an MA prior authorization specialist for the Neurosciences Institute. The caregiver will ... Medical Assistant experience (verified upon hire) + Or current RN /LPN license to practice nursing in the state +...Support Certification (BLS) for healthcare providers. Must be obtained prior to start date + Demonstrated basic computer skills… more
- Humana (Atlanta, GA)
- …looking for an internship that supports the goal to put health first? The Prior Authorization , Registered Nurse , RN , Intern will review prior ... of professional onsite, field, or remote based opportunities. The Prior Authorization , Registered Nurse , RN , Intern will utilize Humana's Medicaid… more
- Dignity Health (Rancho Cordova, CA)
- …skills. - Graduate of an accredited school of nursing. - Clear and current CA Registered Nurse ( RN ) license. **Preferred Qualifications:** - 7 years UM ... and the appropriate application of policies and guidelines to Managed Care prior authorization referral requests. Under general supervision this position is… more
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