- 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 Southern California (Los Angeles, CA)
- …outlined below.The cancer coordinator/navigator is a professional Registered Nurse with oncology specific clinical knowledge who a) participates in the care of ... and treatment stress The nurse navigator screens new patients referred to the Oncology services to ensure patients are directed to the correct services and to… more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The Manager, Network Prior Authorization Services is responsible for monitoring and facilitating the referral ... the department, coordinating day-to-day activities, including direction of the Network Prior Authorization and Referral Specialists. JOB DUTIES AND… more
- MD Anderson Cancer Center (Houston, TX)
- …to comply with institutional standards, initiatives, and guidelines (ABN's, prior authorization requirements, reimbursement optimization, formulary management, ... learning experiences. * Effectively precepts other trainee-required experiences including oncology forum, research projects, grand rounds, MUEs, etc. * Collaborates… more
- Blue KC (Workman, MN)
- …available resources to promote optimal, cost-effective outcomes. Transplant only: Provides prior authorization for, coordinates, and individually manages all ... work appropriately. Additional duties for Transplant only: + Provides prior authorization of the transplant and manages...medical policy. Opens case and follows NCQA case management standards. Documents transplant authorization , issues… more
- Rush University Medical Center (Chicago, IL)
- …site of care. c. Assist in assessing insurance coverage and assist in prior authorization for medications (when necessary) in advance of discharge. Other ... Hematology/ Oncology * Board of Pharmaceutical Specialties Board Certification Board of Oncology Pharmacy Specialty Certification (BCOP) prior to or within 18… more
- Amgen (Philadelphia, PA)
- …on KRYSTEXXA coverage based on their benefits and the steps needed to gain prior authorization to ensure understanding of the process for medication access + ... upon patient enrollment on coverage for Horizon rare disease therapies, common prior authorization requirements, and coding and billings requirements + Provide… more
- AbbVie (North Chicago, IL)
- …groups to develop creative solutions to challenging patient access issues regarding prior authorization , and denied coverage requests to ensure patient care. ... of experience in the healthcare industry with knowledge in reimbursement, billing, prior authorization , appeals, and specialty pharmacy operations + 1-2 years… more
- Banner Health (Mesa, AZ)
- …for department staff, physicians, and patient families. This person will coordinate case time, interface with medical staff and OR scheduling department, assist unit ... high-risk pregnancy and neonatal care, obstetrics and gynecology, pediatrics, cardiology, oncology and emergency medicine. With 33 operating rooms, we offer a… more
- Avera (Sioux Falls, SD)
- …government programs. A successful advocate will communicate with patients, families, case managers, and providers to assess care plans and corresponding coverage ... applications for drug assistance. Provide accurate cost estimate details to patients prior to appointments. + Discuss benefits and other financial concerns with… more