- 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 ... conducts initial, concurrent and retrospective chart reviews for clinical utilization and authorization . The Utilization Review Case Manager coordinates with the… more
- University of Miami (Miami, FL)
- …Case Manager RN - Full Time The University of Miami is currently seeking a Prior Authorization Nurse Case Manager. The incumbent purose is to conduct ... + Adhere and perform timely prospective reviews for services requiring prior authorization + Follows the authorization process using established criteria… more
- Astellas Pharma (Pompano Beach, FL)
- …in payer coverage, healthcare payment models, and utilization management criteria (ie Prior Authorization , Step Edits, other forms of precertification), this ... area relevant to the position, such as ophthalmology/retina, urology or oncology , demonstrating a strong understanding of the specific needs and challenges… more
- Walmart (Orlando, FL)
- …adherence by addressing barriers and coordinating with prescribers, pharmacists, and prior authorization teams. + Monitor patient health status, assess ... in Orlando, FL, and make a meaningful impact in oncology care. As an Oncology Certified Nurse...+ Provide telephonic/video patient education, injection training, and ongoing case management for oncology therapies. + Support… more