- 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 ... reviews for medical necessity and identify the need for authorization . The nurse coordinates with the healthcare...Adhere and perform timely prospective reviews for services requiring prior authorization + Follows the authorization… more
- Centene Corporation (Salem, OR)
- … / LPN license or a compact license. **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
- Select Medical (Knoxville, TN)
- …Hospital - North Knoxville** Critical Illness Recovery Hospitals ** Prior Authorization Specialist/ Payor Relations Specialist** **( RN or LPN required)** ... 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 (West Orange, NJ)
- …- West Orange** A Select Medical Hospital West Orange, NJ ** Prior Authorization Specialist/ Payor Relations Specialist ( RN , LPN )** **Full-Time** **Onsite ... and independent judgment, the Payor Relations Specialist manages the pre-certification and prior authorization of referrals scheduled for admission to the Acute… 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 ... initial, concurrent and retrospective chart reviews for clinical utilization and authorization . The Utilization Review Case Manager coordinates with the healthcare… more
- Molina Healthcare (Layton, UT)
- …**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 (Southaven, MS)
- …**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
- Staffing Solutions Organization (Augusta, ME)
- …a diverse workforce, which is a reflection of our clients and the people they serve. ** Registered Nurse - Authorization Review Unit - Maine DHHS in Augusta, ... business rules and workflow policies. + Work with the Prior Authorization unit staff members to monitor...to develop and implement corrective actions. **Minimum Qualifications:** + Registered Nurse and three (3) years of… more
- 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
- Humana (Oklahoma City, OK)
- **Become a part of our caring community and help us put health first** The Pre- Authorization Nurse 2 reviews prior authorization requests for appropriate ... and approves services or forward requests to the appropriate stakeholder. The Pre- Authorization Nurse 2 work assignments are varied and frequently require… more
Recent Jobs
-
Assoc, Manufacturing Engineering (Huntsville, AL)
- L3Harris (Somerville, AL)
-
2nd Shift Process Development Engineer
- Raytheon Technologies (Andover, MA)
-
Lead, Quality Engineer
- L3Harris (Huntsville, AL)
Related Job Searches:
Authorization,
Manager Prior Authorization RN,
Prior,
Prior Authorization,
RN,
RN Prior,
RN Prior Authorization Supervisor