- Humana (Charleston, WV)
- …part of our caring community and help us put health first** Humana is seeking a Prior Authorization RN to join the Wisconsin Medicaid Market (iCare) team. ... This position reviews the clinical appropriateness of prior authorization (PA) requests and ensures that...make an impact** **Required Qualifications** + Licensed as a Registered Nurse in the State of Wisconsin,… more
- Veterans Affairs, Veterans Health Administration (Beckley, WV)
- …VA administrative and clinical eligibility requirements and works directly with the VAMC Registered Nurse assigned to monitor the clinical care provided to place ... Daily processing of CNH consults as the delegated authority to facilitate authorization of care. Investigating all CNH complaints and visiting the CNH facilities… more
- Veterans Affairs, Veterans Health Administration (Clarksburg, WV)
- …(but is not limited to) Physicians, Physician's Assistants, Nurses, Advanced Registered Nurse Practitioners, Dietitians, Social Workers, and other administrative ... facilities or private hospitals; performing basic eligibility, co-pays and pre- authorization requirements for specific coverage (ie, TRICARE, sharing agreements,… more
- Genesis Healthcare (Hilltop, WV)
- …patient transitions into the skilled nursing setting. + Navigate managed care authorization processes and hospital discharge workflows. + Use CRM tools for timely ... travel statewide for company meetings and education. **Preferred Experience** + Prior experience as a **Clinical Liaison, Admissions Director, Hospital Liaison, Case… more