- Fallon Health (Worcester, MA)
- **Overview** **This is 3 months temporary contract position for a Prior Authorization RN .** **About us:** Fallon Health is a company that cares. We ... Nurse in a clinical setting required. * 2 years' experience as a Utilization Management/ Prior Authorization nurse in a managed care payer preferred. * One… more
- Centene Corporation (New York, NY)
- …**License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + RN - Registered Nurse - State Licensure preferred Pay Range: ... **Must have a New York State nursing license.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service and… 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
- CVS Health (Baton Rouge, LA)
- …heart, each and every day. **Position Summary** The Utilization Management Manager of Prior Authorization oversees a team of clinical professionals to ensure the ... Lead, coach, and develop a multidisciplinary team responsible for utilization review, prior authorization , and case management functions. + Monitor team… more
- Fallon Health (Worcester, MA)
- …and inpatient, utilization management operations, including but not limited to prior authorization , concurrent review and discharge planning. + Ensures ... activities. + Recommends and implements innovative process improvements for the prior authorization and utilization management processes + Develops and… 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
- 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...as indicated by staffing and business needs. **Duties:** + ** Registered Nurse with current license in LA… more
- US Tech Solutions (Wichita, KS)
- …and implementation of QM Work Plan Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in state of residence + Must have ... + MUST HAVE 6 months of Prior Authorization . **Education:** + Active and unrestricted RN ...with Utilization Review? + Do you have an Active Registered Nurse License? **About US Tech Solutions:**… more
- Great River Health (West Burlington, IA)
- …with care team members to efficiently manage tasks such as referrals, prior authorization , phone calls, results notification, and medication refills. + ... & First Aid - American Heart Association within 60 Days Required + Registered Nurse Iowa Board of Nursing (IBON) (United States of America) Upon Hire Required… more
- North Shore Community Health (Salem, MA)
- Registered Nurse Salem, MA (http://maps.google.com/maps?q=47+Congress+Street+Salem+MA+USA+01970) Description Primary Purpose of Position: North Shore Community ... community healthcare delivery. We have an opening for a Registered Nurse . Under the general direction of...when needed within the scope of nursing practice, including prior authorization forms . Provides health education… more
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