- CVS Health (Dover, DE)
- …state of residence. + 3+ years of Nursing experience. Preferred Qualifications + Prior authorization utilization management /review experience preferred ... and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications + Registered Nurse in… more
- Humana (Atlanta, GA)
- …care industry + Previous Medicare/Medicaid experience a plus. + Previous experience in prior authorization , utilization management + Experience working ... that supports the goal to put health first? The Prior Authorization , Registered Nurse, RN, Intern will...review depending on case findings. + Educates providers on utilization and medical management processes. + Enters… more
- Centene Corporation (Olympia, WA)
- …health programs such as mental health parity, community services overutilization, prior authorization , and utilization management reform. + Serve as the ... as mental health parity, community services overutilization, prior authorization , and utilization management reform. + Analyze data related to behavioral… more
- South Central Regional Medical Center (Laurel, MS)
- …(RN) or Licensed Practical Nurse (LPN) license. + Experience in prior authorization , case management , or utilization review preferably in an ambulatory ... REGISTERED NURSE Position: RN Department: Prior Authorization Reports to: Department Manager...departments, and clinical teams to streamline workflows for both prior authorizations and patient drug program management .… more
- Centene Corporation (Jefferson City, MO)
- …**Position Purpose:** Oversee operations of the referral management , telephonic utilization review, prior authorization , and various related functions ... Committee for Quality Assurance (NCQA) standards for utilization management functions, prior authorization and concurrent review units + Collaborate with… more
- Elevance Health (San Antonio, TX)
- …personalized support throughout the consumer's treatment journey. **Title:** Utilization Management Representative II - Prior Authorization **Location:** ... Possibilities. Make an extraordinary impact.** The Utilization Management Representative II - Prior Authorization... Utilization Management Representative II - Prior Authorization is responsible for managing incoming… more
- Sanford Health (SD)
- …team regarding trends, external regulations and internal policies that effect resource utilization and potentially, prior authorization . Assists the ... Conduct level of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to… more
- Sanford Health (WI)
- …**Weekly Hours:** 40.00 **Salary Range:** $21.50 - $28.00 **Job Summary** Monitors the utilization of resources, risk management and quality of care for patients ... Collection of clinical information necessary to initiate commercial payor authorization . Obtain and maintain appropriate documentation concerning services in… more
- Banner Health (AZ)
- …clinical data as necessary for pharmacist review and complete a prior authorization or other utilization management function, contact members regarding ... Primary responsibilities include pre-screening and support functions for Medication Therapy Management and Prior Authorizations. Other support functions include… more
- US Tech Solutions (LA)
- …walls of a hospital setting in a specialty area of the nursing field providing utilization management prior authorization reviews. Build strong direct ... Minimum 3 years nursing experience with a minimum of 1 year in utilization management / prior authorization review experience. **Experience** : … more
Recent Jobs
-
Staff Performance Support Consultant (Escalations Engineering)
- ServiceNow, Inc. (Orlando, FL)
-
Workday Integrations Developer
- Sunrise Senior Living (Mclean, VA)
-
Senior AEM Developer
- Crown Equipment Corporation (Troy, OH)
-
Java Full Stack Development Engineering Lead
- Citigroup (Irving, TX)
Related Job Searches:
Authorization,
Management,
Management Prior,
Prior,
Prior Authorization,
Utilization,
Utilization Management