- 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
- Blue KC (KS)
- …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
- Hackensack Meridian Health (Hackensack, NJ)
- …/Radiation Oncology services in the HMH Health care system. This pertains to Prior Authorization for Oncology services, as well as various specialized ... portals where clinical data is submitted to substantiate the request for prior approvals for oncology services. **Education, Knowledge, Skills and Abilities… 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
- Hartford HealthCare (Bridgeport, CT)
- …and insurance requirements, ensuring all necessary paperwork and required tests needed prior to surgery are accurately completed, and clearly communicated pre- and ... and provides consistent documentation in EPIC to support the obtained insurance authorization . Communicates changes in payer and or federal regulatory guidelines to… more
- Cardinal Health (Nashville, TN)
- …management specialists simplify and optimize the practice's revenue cycle, from prior authorization through billing and collections. **Job Description** The ... **_What Benefits Eligibility and Authorization (RCM) contributes to Cardinal Health_** Practice Operations...such as deductible, out of pocket, copay and coinsurance prior to services rendered. + Verify if any … more
- University of Rochester (Albany, NY)
- …data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical ... Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500223 Radiation Oncology SMH Work Shift: UR - Day (United States of America) Range: UR… 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
- 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
- Rush University Medical Center (Chicago, IL)
- …activities and processes include but are not limited to completing prior authorizations for oncology specialty medications, providing insurance-related ... in accordance with Rush policies and procedures. **Responsibilities** * Completes prior authorizations for Oncology Specialty medications utilizing all resources… more