- Humana (Trenton, NJ)
- …part of our caring community and help us put health first** Humana is seeking a Prior Authorization RN to join the Wisconsin Medicaid Market (iCare) team. ... This position reviews the clinical appropriateness of prior authorization (PA) requests and ensures that...make an impact** **Required Qualifications** + Licensed as a Registered Nurse in the State of Wisconsin,… more
- Hunterdon Health Care System (Flemington, NJ)
- …conducted through the application of evidence-based criteria or guidelines, and through authorization / prior authorization under the provisions of an ... Degree in nursing OR if Associates Degree or Diploma, RN must provide proof of enrollment in a BSN...must provide proof of enrollment in a BSN program prior to hire, be continuously enrolled and complete within… more
- CVS Health (Trenton, NJ)
- …be able to work an Eastern Standard Time schedule** **Must be a licensed Registered Nurse , any compact licensure must cover New Jersey** + Utilization Management ... **Required Qualifications** + Must have active, current and unrestricted RN licensure in New Jersey or Compact RN...(Teams, Outlook, Word, Excel, etc.) **Preferred Qualifications** + Previous prior authorization experience + Prior … more
- BriteLife Recovery (Englewood, NJ)
- …overseeing and coordinating all aspects of utilization review and insurance authorization for clients receiving substance use disorder (SUD) treatment at Britelife ... and intensive outpatient (IOP) levels of care. + Obtain prior authorizations and continued stay approvals from commercial and...a related field required; advanced degree or licensure (eg, RN , LCSW, LPC, LMHC, or CADC) preferred. + Excellent… more