- CVS Health (Baton Rouge, LA)
- …And we do it all with heart, each and every day. **Position Summary** The Team Lead is accountable to leadership to support the day to day operations of the ... team . This position has no supervisory oversight of staff,...point and first line of contact for staff for clinical issues. They may lead projects as assigned. The… more
- CVS Health (Phoenix, AZ)
- …for clinical and legal review. + Provides day-to-day support and guidance for ABA prior authorization clinical team and the health plan medical ... is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources. Under the direction… more
- CVS Health (Baton Rouge, LA)
- …to Applied Behavior Analysis (ABA). * Provide daily support and guidance to the ABA prior authorization clinical team and health plan medical directors. ... system that is transparent, consumer-focused, and acknowledges physicians for their clinical excellence and effective utilization of health care resources. Reporting… more
- CVS Health (Baton Rouge, LA)
- …and every day. **Position Summary** The Utilization Management Manager of Prior Authorization oversees a team of clinical professionals to ensure the ... Lead, coach, and develop a multidisciplinary team responsible for utilization review, prior authorization , and case management functions. + Monitor team … more
- Elevance Health (Seven Hills, OH)
- …industry. **Build the Possibilities. Make an Extraordinary Impact.** **Title** : Clinical Pharmacist ( Prior Authorization ) **Location(s):** + Indianapolis, ... **Be Part of an Extraordinary Team ** CarelonRx is a proud member of the...By leveraging the power of new technologies, our strong, clinical -first lens and deep pharmacy expertise, we are actively… more
- CVS Health (Austin, TX)
- …and utilizes various computer resources, existing criteria, and medication guidelines to perform clinical research to support prior authorization reviews. - ... And we do it all with heart, each and every day. **Position Summary** - Processes prior authorization requests received by phone, fax, or electronically,… more
- University of Utah Health (Salt Lake City, UT)
- …verification, obtaining benefit information, calculating patient estimates and obtaining prior authorization before services are rendered. This position ... individual payer requires to authorize the visit. + Secures prior authorization for high dollar services such...of work. + Ability to work independently within a team setting. + Consistently demonstrates positive attitude when interacting… more
- University of Southern California (Newport Beach, CA)
- The Clinical Authorization Specialist will take the lead in securing medical authorizations from third party payers (commercial and government) for outpatient ... clinical documentation for chemotherapy authorizations in Keckcare for authorization submission from Medical/Nursing Staff + Submit pre-certification/pre determination… more
- Omaha Children's Hospital (Omaha, NE)
- …to identify authorization trends, payer barriers, and denial patterns. + Clinical Coordination + Participate in interdisciplinary treatment team meetings to ... veterans and people with disabilities. **A Brief Overview** The Prior Authorization Therapist serves as a licensed...& Advocacy + Serve as the liaison between the clinical team , revenue cycle, and payer representatives.… more
- Fallon Health (Worcester, MA)
- **Overview** **This is 3 months temporary contract position for a Prior Authorization RN.** **About us:** Fallon Health is a company that cares. We prioritize ... information from medical care providers as needed for the clinical review process * Conducts pre- authorization and...setting required. * 2 years' experience as a Utilization Management/ Prior Authorization nurse in a managed care… more
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