- Molina Healthcare (Temecula, CA)
- **_JOB TITLE: CARE REVIEW CLINICIAN , PRIOR AUTHORIZATION (REGISTERED NURSE , OR LVN)_** **For this position we are seeking a Nurse with previous ... benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina… more
- Molina Healthcare (Las Vegas, NV)
- …benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina ... **_For this position we are seeking a (RN) Registered Nurse with previous experience in Hospital Acute Care, Concurrent...+ Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. +… more
- Molina Healthcare (Lexington, KY)
- …financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed. + Processes ... **CARE REVIEW CLINICIAN INPATIENT REVIEW REGISTERED NURSE : KENTUCKY REMOTE** **(2 openings)** **_For this position we are seeking a Registered Nurse with… more
- Ascension Health (Schaumburg, IL)
- …specifics._ **Responsibilities** Ascension Illinois is looking for an Advanced Practice Clinician , Physician Assistant or Nurse Practitioner for our Neurology ... duties for the neurology service such as managing clinical questions, insurance pre- authorization peer reviews, and form completion + Acts as a resource to… more
- Carle (Urbana, IL)
- Behavioral Health Clinician (LCSW, LCPC, LMFT) - Senior Behavioral Health 3 West + Department: Senior Behavioral Hlth - CPRH + Entity: Peoria Service Area + Job ... admission assessments and intakes at the direction of the Nurse Manager* When assisting as a team member to...is clinically appropriate and that plan is in place prior to discharge.* Keeps patient/family informed of plans as… more
- Molina Healthcare (KY)
- …benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina ... its members. + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional… more
- Molina Healthcare (Bowling Green, KY)
- …financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed. + Processes ... **_For this position we are seeking a Registered Nurse or Licensed Social Worker with PSYCH /...for this role. We can consider a RN (Registered Nurse ), LCSW, LMFT, or LPCC._** **_WORK SCHEDULE: SUNDAY thru… more
- Centene Corporation (Baton Rouge, LA)
- …services to ensure level of care and services are medically appropriate + Performs prior authorization reviews related to mental health and substance abuse to ... Licensed Mental Health Professional (LMHP) + RN - Registered Nurse - State Licensure and/or Compact State Licensure required...Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required… more
- Molina Healthcare (Richmond, KY)
- …financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed. + Processes ... **_For this position we are seeking a (RN) Registered Nurse with previous experience in Hospital Acute Care, Concurrent Review/ Utilization Review / Utilization… more
- Molina Healthcare (Milwaukee, WI)
- …financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed. + Processes ... **JOB DESCRIPTION** **_For this position we are seeking a (RN) Registered Nurse with previous experience in Hospital Acute Care, Concurrent Review/ Utilization… more
- Centene Corporation (Tallahassee, FL)
- …(BH) and/or autism spectrum disorder needs and clinical standards + Performs prior authorization reviews related to BH to determine medical appropriateness ... + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required + Board Certified Behavior… more
- US Tech Solutions (Chicago, IL)
- …an RN + Registered Nurse in state of residence + Must have prior authorization utilization experience + Experience with Medcompass **Skills:** + MUST HAVE ... MANAGEMENT EXP, pref. knowledge of Milliman/MCG. + MUST HAVE 6 months of Prior Authorization . **Education:** + Active and unrestricted RN licensure in state… more
- Hillside Family of Agencies (Rochester, NY)
- …process to obtain medical/psychiatric history, establish health care needs, and complete prior authorization for medications or medical necessity based on ... coordinate with treatment team providers such as the treating physician, nurse practitioner, and clinician , as well as others to assess, plan, implement, and/or… more
- Hillside Family of Agencies (Rochester, NY)
- …pre-placements to obtain medical/psychiatric history, establish health care needs, and complete prior authorization for medications or medical necessity based on ... coordinate with treatment team providers such as the treating physician, nurse practitioner, and clinician , as well as others to assess, plan, implement, and/or… more
- Option Care Health (Tappahannock, VA)
- …a diverse workforce. **Job Description Summary:** Hiring Range From $43.80/Hr An Infusion Nurse is a licensed clinician who coordinates and provides direct ... an accredited school of nursing and at least 1 year of experience as a registered nurse or recent graduate with prior experience as an IV Certified LVN/LPN with… more
- Option Care Health (Rutland, VT)
- …employment will be terminated. **Job Description Summary:** Hiring Range From $42.25An Infusion Nurse is a licensed clinician who coordinates and provides direct ... an accredited school of nursing and at least 1 year of experience as a registered nurse or recent graduate with prior experience as an IV Certified LVN/LPN with… more
- US Tech Solutions (May, OK)
- …experience . Registered Nurse in state of residence . Must have prior authorization utilization experience . Able to work in multiple IT platforms/systems ... MANAGEMENT EXP, pref. knowledge of Milliman/MCG. . MUST HAVE 6 months of Prior Authorization . Education: . Active and unrestricted RN licensure in state… more
- US Tech Solutions (RI)
- …experience required. + Must have experience with Medcompass + Must have prior authorization utilization experience. + Managed Care/Medicare experience preferred. ... MANAGEMENT EXP, pref. knowledge of Milliman/MCG. + MUST HAVE 6 months of Prior Authorization . **Education:** + RN with current unrestricted state licensure… more
- Carle (Urbana, IL)
- …adults, and senior adults.* Completes and submits documentation for medication prior authorizations + Works in conjunction with the interdisciplinary team to ... process with the psychiatrist, primary nursing staff, mental health clinician , and discharge planner as soon after admission as...when requested.* During times of high census, collaborates with Nurse Manager and /or Lead Nurse to… more
- University of Utah Health (Salt Lake City, UT)
- …for evaluation. Collaborates with Transplant Financial Coordinators to assure appropriate authorization obtained for patients prior to evaluation visit. + ... our mission. EO/AA_ Under the direction of the RN Nurse Coordinator and Transplant Management, the Transplant Program Specialist...and assure completion and appropriate follow up by transplant clinician of all orders in EMR and OSH +… more