- Humana (Frankfort, KY)
- …a part of our caring community and help us put health first** The Pre- Authorization Nurse 2 reviews prior authorization requests for appropriate care ... and approves services or forward requests to the appropriate stakeholder. The Pre- Authorization Nurse 2 work assignments are varied and frequently require… more
- Humana (Enid, OK)
- …for an internship that supports the goal to put health first? The Prior Authorization , Registered Nurse , RN, Intern will review prior authorization requests ... variety of professional onsite, field, or remote based opportunities. The Prior Authorization , Registered Nurse , RN, Intern will utilize Humana's Medicaid… more
- Health First (Rockledge, FL)
- …**Medical Management* **Organization:** **HF Administrative Plan Inc* **Title:** *Prior Authorization Nurse Specialist HFHP - Clinical Operations* **Location:** ... a sustainable, measurable, accurate, reliable and timely execution of the Prior Authorization Process. Success in this position will be based on the individual's… more
- Centene Corporation (Sacramento, CA)
- …must have CA RN Licensure.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service and appropriate level ... of medical care. + Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in accordance with… more
- Atlantic Health System (Morristown, NJ)
- …services to obstetrical patients 2. Communicate effectively with internal departments and insurance companies to obtain necessary authorization 3. Gather and ... medical records, treatment plans, and other relevant documentation required for authorization . 4. Ensure all documentation provided meets insurance company… more
- Baptist Memorial (Memphis, TN)
- Summary The Authorization Coordinator is responsible for facilitating information documentation and transmission vital to the effectiveness of utilization review and ... Specifically the managed care techniques the Coordinator uses focuses on prior authorization for services using evidence based criteria. Areas of work include payer… more
- Select Medical (St. Charles, MO)
- …**Select Specialty Hospitals - St Louis** **Critical Illness Recovery Hospital** **Prior Authorization Specialist / Payor Relations Specialist ( RN , LPN )** ... Relations Specialist, you will manage the pre-certification and prior authorization of referrals scheduled for admission to our hospital....in third party reimbursement. + Must be a Registered Nurse (RN) or Licensed Practical Nurse (LPN).… more
- Sanford Health (ND)
- …reported. Provide information via multiple sources of technology applications to insurance companies and contracted vendors to assure authorization for ... experience required. Specific background or experience in healthcare reimbursement, insurance industry, and/or authorization experience would be critical… more
- Atlantic Health System (Morristown, NJ)
- Registered Nurse , Women's Health Authorization Specialist Responsibilities: + Coordinate and oversee all obstetrical and gynecological authorizations with CMA ... medications, and medical procedures. + Communicate effectively with internal departments and insurance companies to obtain necessary authorization . + Gather and… more
- Commonwealth of Pennsylvania (PA)
- …& ELIGIBILITY QUALIFICATIONS Necessary Special Requirements: + This position requires active authorization to practice as a Registered Nurse in Pennsylvania. + ... refer to ourFAQ page (https://www.employment.pa.gov/Additional%20Info/Pages/default.aspx) . + Yes 02 Registered Nurse - Do you possess active authorization to… more
- Commonwealth of Pennsylvania (PA)
- …& ELIGIBILITY QUALIFICATIONS Necessary Special Requirements: + This position requires active authorization to practice as a Registered Nurse in Pennsylvania. + ... refer to ourFAQ page (https://www.employment.pa.gov/Additional%20Info/Pages/default.aspx) . + Yes 02 Registered Nurse - Do you possess active authorization to… more
- The Cigna Group (Bloomfield, CT)
- Nurse Case Management Lead Analyst- Nurse Clinician - Accredo Job Description Summary The Nurse Clinician - RN is responsible for reviewing escalated clinical ... providers, members and patient client advocates within the Prior Authorization /Utilization Management department. Identify and track trends for analytics reporting… more
- System One (Baltimore, MD)
- ALTA IT Services is staffing a contract to hire opportunity for a Utilization Management Nurse to support a leading health insurance customer. The UM Nurse ... will perform prospective, concurrent and retrospective reviews for authorization , appropriateness of care determination and benefit coverage. Leveraging clinical… more
- Baptist Memorial (Memphis, TN)
- Summary Works directly under the supervision of a professional registered nurse . Coordinates and provides care utilizing the critical thinking framework known as the ... nursing process. The nursing process forms the foundation of the nurse 's decision making to help partner with patients/families to attain, maintain and restore… more
- Louisiana Department of State Civil Service (Kinder, LA)
- REGISTERED NURSE 1, 2, OR 3 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4567658) Apply REGISTERED NURSE 1, 2, OR 3 Salary Depends on ... has a Special Entrance Rate at each level. Registered Nurse 1 has an SER of $29.84 per hour....benefits package including; a defined benefit pension plan, health insurance that is also available post retirement, at least… more
- Louisiana Department of State Civil Service (Kinder, LA)
- PRACTICAL NURSE -LICENSED 1, 2, OR 3 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4567726) Apply PRACTICAL NURSE -LICENSED 1, 2, OR 3 ... has a Special Entrance Rate at each level Practical Nurse -Licensed 1 has an SER of $19.48 per hour....benefits package including; a defined benefit pension plan, health insurance that is also available post retirement, at least… more
- Access Dubuque (Dubuque, IA)
- Nurse Assistant CVU PRN **MercyOne** 1 Positions ID: TRHEUS00548289MERCYO Posted On 11/01/2024 **Job Overview** **Employment Type:** Part time **Shift:** Rotating ... Shift **Description:** **POSITION PURPOSE:** The Nurse Assistant (NA) is a member of the MercyOne...+ Wellness programs + Education reimbursement + Personalized health insurance plans including dental and vision + Paid time… more
- Louisiana Department of State Civil Service (Homer, LA)
- PRACTICAL NURSE --LICENSED 1, 2, OR 3 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4532086) Apply PRACTICAL NURSE --LICENSED 1, 2, OR 3 ... has a Special Entrance Rate at each level: Practical Nurse -Licensed 1 has an SER of $19.48 per hour....benefits package including; a defined benefit pension plan, health insurance that is also available post retirement, at least… more
- The Arora Group (Bethesda, MD)
- …outpatients in a timely fashion. + The Contractor shall perform pre-cert and authorization of insurance pertaining to patient admission and surgical admission as ... Licensed Practical Nurse (LPN) - Utilization Review Nurse ...& Welfare allowance mostly cover the cost of health insurance , long and short-term disability, and life insurance… more
- Kelly Services (Jacksonville, AR)
- …essential in ensuring students continue to learn and grow every day. A substitute school nurse may also be referred to as Registered Nurse (RN) or Licensed ... * 18+ years of age * High school diploma or GED * Licensed Practical Nurse or Registered Nurse * Arkansas Division of Elementary & Secondary Education background… more