- Centene Corporation (New York, NY)
- …have an active New York State nursing license.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service ... medical necessity of care of member + Escalates prior authorization requests to Medical ...management processes preferred. **License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + RN - Registered… more
- Centene Corporation (Oklahoma City, OK)
- …to resolve cases and support member/provider needs.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of ... medical necessity of care of member + Escalates prior authorization requests to Medical ...utilization management processes preferred. **License/Certification:** LPN - Licensed Practical Nurse - State Licensure req Pay Range: $26.50 -… more
- US Tech Solutions (May, OK)
- …pharmacists, other clinical colleagues, healthcare professionals and members. + Follow all prior authorization procedures to guarantee an accurate process on ... following policy and procedure. + Provide on-call after hours nurse availability for urgent PA requests. + Provide internal...each prior authorization . + Train and mentor representatives… more
- UCLA Health (Los Angeles, CA)
- …clinical documentation related to prior authorization requests for medical services. The UM Review Nurse applies clinical judgment, regulatory standards, ... Description At UCLA Health, the Utilization Management (UM) Review Nurse plays a vital role in ensuring the delivery...of resources. Key Responsibilities: + Conducts clinical reviews of prior authorization requests to evaluate medical… more
- Humana (Oklahoma City, OK)
- **Become a part of our caring community and help us put health first** The Pre- Authorization Nurse 2 reviews prior authorization requests for appropriate ... and independent determination of the appropriate courses of action. The Pre- Authorization Nurse 2 completes medical necessity and level of care… more
- Humana (Frankfort, KY)
- **Become a part of our caring community and help us put health first** The Pre- Authorization Nurse 2 reviews prior authorization requests for appropriate ... services or forward requests to the appropriate stakeholder. The Pre- Authorization Nurse 2 work assignments are varied...to Tier III care management as needed. * Perform prior authorization reviews according to established HUMANA… more
- 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 ... **This is 3 months temporary contract position for a Prior Authorization RN.** **About us:** Fallon Health... uses a multidisciplinary approach to review service requests ( prior -authorizations), focusing on selected complex medical and… more
- Hartford HealthCare (Manchester, CT)
- …* Associate's degree preferred. *EXPERIENCE:* * 2 years Hospital or medical office insurance/ authorization /precertification/referral work experience. * 2 ... years customer service. *COMPETENCIES:* * Knowledge of Medical Insurance and authorization process. * Current with CPT and ICD-10 Codes. * Medical … more
- Aspirus Ironwood Hospital (Wausau, WI)
- …WI is seeking an AUTHORIZATION SPECIALIST to join our team! The Authorization Specialist is critical to ensure accurate prior and ongoing authorizations. ... and communication with the patients, clinical team including physicians, nurse practitioners, patient navigator, pharmacy staff, and patient financial services… more
- Trinity Health (Syracuse, NY)
- …This role focuses on monitoring expirations of referrals, verifying insurance updates prior to procedure, and supporting authorization and denial processes. ... we are. + **POSITION SUMMARY:** Reviews, analyzes, and interprets complex medical information, applying specific knowledge of coding requirements and conventions to… more
- Mayo Clinic (Rochester, MN)
- …and written). Experience working in a team environment. Computer skills required, prior experience with electronic medical record systems preferred. Ability to ... can build a long, successful career with Mayo Clinic. **Benefits Highlights** + Medical : Multiple plan options. + Dental: Delta Dental or reimbursement account for… more
- Mayo Clinic (Rochester, MN)
- …classes. Nurses continue their education by attending neuroscience specialty days and medical specialty nursing conferences. The registered nurse (RN) is ... and written). Experience working in a team environment. Computer skills required, prior experience with electronic medical record systems preferred. Ability to… more
- Mayo Clinic (Rochester, MN)
- …and written). Experience working in a team environment. Computer skills required, prior experience with electronic medical record systems preferred. Ability to ... long, successful career with Mayo Clinic. **Benefits Highlights** + Medical : Multiple plan options. + Dental: Delta Dental or...Model is the nursing care delivery system. The registered nurse (RN) is accountable for the coordination of nursing… more
- Mayo Clinic (Rochester, MN)
- …and written). Experience working in a team environment. Computer skills required, prior experience with electronic medical record systems preferred. Ability to ... can build a long, successful career with Mayo Clinic. **Benefits Highlights** + Medical : Multiple plan options. + Dental: Delta Dental or reimbursement account for… more
- Mayo Clinic (Mankato, MN)
- …a full-time Nurse Practitioner or Physician Assistant to join our Medical Oncology practice. This position will be based in **Mankato** with potential for ... can build a long, successful career with Mayo Clinic. **Benefits Highlights** + Medical : Multiple plan options. + Dental: Delta Dental or reimbursement account for… more
- Mayo Clinic (Lake City, MN)
- …can build a long, successful career with Mayo Clinic. **Benefits Highlights** + Medical : Multiple plan options. + Dental: Delta Dental or reimbursement account for ... of practice experience, hired into a scheduled FTE Registered Nurse position are automatically enrolled in the Nurse...associate degree registered nurses with a RN start date prior to April 1, 2020 must provide documented evidence… more
- US Tech Solutions (GA)
- …medication prior authorization (PA) requests reviewed by the Specialty Medical Prior Authorization department. Reporting to the Pharmacy Operations ... staff and customer service, admissions and pharmacy operations departments to communicate prior authorization status. You will also oversee fax processing and… more
- Mayo Clinic (Cannon Falls, MN)
- …can build a long, successful career with Mayo Clinic. **Benefits Highlights** + Medical : Multiple plan options. + Dental: Delta Dental or reimbursement account for ... of practice experience, hired into a scheduled FTE Registered Nurse position are automatically enrolled in the Nurse...associate degree registered nurses with a RN start date prior to April 1, 2020 must provide documented evidence… more
- State of Colorado (Golden, CO)
- …with outside providers for the committed and detained youth. Point of contact for prior authorization for specialized medical care. Responsible to track all ... Lead Mid-Level Provider / Nurse Practitioner - Campus at Lookout Mountain Youth... prior authorization requests to ensure accuracy and follow-through. Participates or… more
- Louisiana Department of State Civil Service (St. Gabriel, LA)
- PRACTICAL NURSE -LICENSED 1, 2, OR 3 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4776460) 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....employee may be required to serve a trial detail prior to being permanently promoted. + TEMPORARY JOB APPOINTMENT:… more