- CHRISTUS Health (Alamogordo, NM)
- …that patient results, x-rays, labs and procedure reports are in patient charts prior to seeing doctor. * Gather patient's vitals and complaints, document in patient ... portions of chart preparation. * Schedule surgery and give patient appropriate instructions prior to surgery and refer to Front Office Coordinator or Office Manager… more
- CHRISTUS Health (Alamogordo, NM)
- …that patient results, x-rays, labs and procedure reports are in patient charts prior to seeing doctor. * Gather patient's vitals and complaints, document in patient ... portions of chart preparation. * Schedule surgery and give patient appropriate instructions prior to surgery and refer to Front Office Coordinator or Office Manager… more
- Health First (Rockledge, FL)
- …skills. **Job:** **Medical Management* **Organization:** **HF Administrative Plan Inc* **Title:** * Prior Authorization Nurse Specialist HFHP - Clinical ... acute care setting is preferred. * Prior Authorization Experience is preferred. * RN or LPN with current unrestricted Florida Licensure. *PHYSICAL DEMANDS:*… more
- Centene Corporation (Sacramento, CA)
- …Candidate must have CA RN Licensure.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service and ... interdepartmental teams, to assess medical necessity of care of member + Escalates prior authorization requests to Medical Directors as appropriate to determine… more
- Select Medical (St. Charles, MO)
- …**Select Specialty Hospitals - St Louis** **Critical Illness Recovery Hospital** ** Prior Authorization Specialist / Payor Relations Specialist ( RN , LPN )** ... least two (2) years of direct experience in third party reimbursement. + Must be a Registered Nurse ( RN ) or Licensed Practical Nurse (LPN). Preferred… more
- Molina Healthcare (San Bernardino, CA)
- _JOB TITLE: CARE REVIEW CLINICIAN, PRIOR AUTHORIZATION ( REGISTERED NURSE , OR LVN)_ **JOB DESCRIPTION** **Job Summary** Molina Healthcare Services (HCS) ... **JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse ( RN ), Licensed Vocational Nurse (LVN)… more
- Molina Healthcare (ID)
- …**JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse ( RN ), Licensed Vocational Nurse (LVN) ... medical clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ), Licensed Vocational Nurse … more
- Humana (Enid, OK)
- …looking for an internship that supports the goal to put health first? The Prior Authorization , Registered Nurse , RN , Intern will review prior ... of professional onsite, field, or remote based opportunities. The Prior Authorization , Registered Nurse , RN , Intern will utilize Humana's Medicaid… 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...Qualifications - What it takes to Succeed** + Licensed Registered Nurse ( RN ) in the… more
- Essentia Health (Duluth, MN)
- …to perform all aspects of managed care, including the referral, prior authorization /precertification processes, using and revising Essentia Health's established ... policies and procedures for managed care activities. Performs complex care coordination and referral management. Works collaboratively with the Essentia Health customer service personnel to provide efficient service for insurance issue resolution and smooth… more
- Molina Healthcare (IA)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina… more
- Molina Healthcare (UT)
- …_For this position we are seeking a ( RN ) Registered Nurse , with previous experience in Prior Authorizations, Utilization Review / Utilization Management ... for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of… more
- Atlantic Health System (Morristown, NJ)
- Registered Nurse , Women's Health Authorization Specialist Responsibilities: + Coordinate and oversee all obstetrical and gynecological authorizations with ... CMA Prior Authorization Specialist. Primary responsibility will be...authorization requirements and processes. + Work in an RN role with patients in various Women's Health departments… more
- US Tech Solutions (LA)
- **Position Summary:** As a Prior Authorization Nurse , you work outside the walls of a hospital setting in a specialty area of the nursing field providing ... utilization management prior authorization reviews. Build strong direct relationships...as indicated by staffing and business needs. **Duties:** + ** Registered Nurse with current license in LA… more
- US Tech Solutions (Wichita, KS)
- …and implementation of QM Work Plan Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in state of residence + Must have ... + MUST HAVE 6 months of Prior Authorization . **Education:** + Active and unrestricted RN ...with Utilization Review? + Do you have an Active Registered Nurse License? **About US Tech Solutions:**… more
- SSM Health (Janesville, WI)
- …Support HealthCare Provider (BLS HCP) - American Heart Association (AHA) + And + Registered Nurse ( RN ) - Missouri Division of Professional Registration + ... accuracy and timeliness on all functions related to insurance prior authorization , plan benefits, and medical necessity...Or + Registered Nurse ( RN ) Issued by...Or + Registered Nurse ( RN ) Issued by Compact State State… more
- Beth Israel Lahey Health (Beverly, MA)
- …team, Resource nurse and pharmacy as the clinical representative to ensure prior authorization and delivery of chemotherapy agents. * Assesses the physical ... and psychosocial status of clients by means of interview, health history, physical examination, and diagnostic studies. * Completes objective and accurate documentation of patient care in the electronic health record * Collaborate in organizing community… more
- Ascension Health (Tulsa, OK)
- …inpatient utilization management programs. + Oversee implementation and maintenance of prior authorization codes for all clients. **Requirements** Licensure / ... Certification / Registration: + Registered Nurse credentialed from the Oklahoma Board... credentialed from the Oklahoma Board of Nursing obtained prior to hire date or job transfer date required.… more
- Premier Health (Dayton, OH)
- **Position: Registered Nurse ( RN )** **Facility: Miami Valley Hospital & Miami Valley Hospital South** **Department:** **Pain Center** **Shift: PRN Support/ ... policy, diagnostic testing and other information by phone; and insurance prior authorization for procedures, medications, and emergent diagnostic testing.… more
- Health First (Melbourne, FL)
- …your professional nursing career; Join Health First! PLEASE NOTE: You need only apply for the Registered Nurse ( RN ) - New to Practice position and do not ... Applicants may apply, interview, and receive a contingent offer prior to receiving their Authorization to Test...Nurse * **Organization:** **Health First Shared Svcs Inc* **Title:** * Registered Nurse ( RN ) - … more
