- Fallon Health (Worcester, MA)
- …Nurse in a clinical setting required. + 2 years' experience as a Utilization Management/ Prior Authorization nurse in a managed care payer preferred. + One ... in nursing required** **License/Certifications** + Active and unrestricted licensure as a Registered Nurse in Massachusetts. **Experience** + A minimum of three… more
- Mayo Clinic (Jacksonville, FL)
- …+ Retirement: Competitive retirement package to secure your future. **Responsibilities** The registered nurse ( RN ) is accountable for the coordination ... entry-level associate degree registered nurses with a RN start date prior to April 1,...from each new employee's Form I-9 to confirm work authorization . **Recruiter** Jorida Musta **Equal opportunity** As an Affirmative… more
- Staffing Solutions Organization (Augusta, ME)
- …a diverse workforce, which is a reflection of our clients and the people they serve. ** Registered Nurse - Authorization Review Unit - Maine DHHS in Augusta, ... business rules and workflow policies. + Work with the Prior Authorization unit staff members to monitor...to develop and implement corrective actions. **Minimum Qualifications:** + Registered Nurse and three (3) years of… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse ( RN ) Manager,...Knowledge of Coordination of Care, Medicare and Medi-Cal regulations, prior authorization , level of care and length ... + Excellent verbal, written communication and presentation skills. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and… more
- Actalent (Sacramento, CA)
- Job Title: Appeals and Grievances Registered Nurse Job Description We are seeking a skilled professional to join our team and handle member appeals and ... and Medicare Health Coverage Benefits and Reviews. + Experience with prior authorization , pre-service and post-service review, appeals, utilization management,… more
- Centene Corporation (New York, NY)
- …**License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + RN - Registered Nurse - State Licensure preferred Pay Range: ... New York State nursing license.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity...holidays, and a flexible approach to work with remote, hybrid , field or office work schedules. Actual pay will… more
- UPMC (Pittsburgh, PA)
- …within 30 days of hire + Basic Life Support (BLS) OR Cardiopulmonary Resuscitation (CPR) + Registered Nurse ( RN ) + Act 33 with renewal + Act 34 with ... orientation. **Position Specifics:** Employee with be assisting providers with obtaining prior authorization for treatment and completing required documentation… more
- UCLA Health (Los Angeles, CA)
- …compliance with regulations and contracts, care coordination and continuity of care, prior authorization and denial management, education and provider support, ... the Assistant Director, the ICM Medicare Advantage Utilization Review Nurse performs utilization review of medical necessity and appropriateness,...Required: + BSN or MSN degree + Active CA RN License + Minimum of 2 years' experience in… more
- Hillside Family of Agencies (NY)
- …of youth/individuals. This role may also include performing all clinical functions of a Registered Nurse ( RN ). This is a full-time (40 hours) position, ... for this to be a partial hybrid /remote role. Are you a compassionate, experienced Registered Nurse looking to make a positive impact on the lives of foster… more
- MD Anderson Cancer Center (Houston, TX)
- …and other health professionals to complete research initiatives. * Advanced Practice Registered Nurse : * *EDUCATION* Required: Master's Degree in Nursing or ... for applicants who obtained recognition as an Advanced Practice Registered Nurse from the Texas State Board...Nurse from the Texas State Board of Nursing prior to 1/1/2003. Graduate education and related Texas Board… more