- 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
- Ascension Health (Wichita, KS)
- **Details** + **Department:** Prior Authorization Radiology/Radiation Oncology + **Schedule:** Full Time, Day Shift, Mon-Fri, 8am-5pm + **Clinic:** Via ... **Responsibilities** Coordinate with physician offices and insurance companies in obtaining authorization for all hospital admissions. + Obtain authorization on… 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
- University of Rochester (Rochester, 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
- 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
- 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