- Centene Corporation (Phoenix, AZ)
- …LPN license or Compact RN license.** **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
- Humana (Fort Lauderdale, FL)
- …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
- Fallon Health (Worcester, MA)
- …and notifications for FCHP members, screens for member eligibility, additional active insurance coverage and authorization history from the core system. + ... authorization information in QNXT as a result of determinations made by Authorization Coordinators, Nurse Reviewers and/or Nurse Care Specialists. +… 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
- CVS Health (Austin, TX)
- …and affordable. Candidates **MUST HAVE AT LEAST TWO YEARS OF** prior authorization experience. Schedule: For training there is a set schedule 8am-430pm CST ... in accordance with CVS/Caremark policies and procedures. * Refer prior authorization cases not meeting clinical criteria for upper-level review when appropriate.… more
- Select Medical (Columbus, OH)
- …Hospitals - Columbus** **Critical Illness Recovery Hospital** **Columbus, OH** **Prior Authorization Specialist / Payor Relations Specialist (Precert Nurse )** ... 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
- 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
- Sanford Health (SD)
- …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
- CVS Health (Oklahoma City, OK)
- …and written **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active, current and unrestricted Oklahoma RN licensure + Must ... business needs **Preferred Qualifications** + Utilization management, precertification, prior authorization experience strongly preferred + Managed Care experience preferred… more
- MD Anderson Cancer Center (Houston, TX)
- …Must be able to work in a fast-paced clinic.** **Experience with prior authorization , insurance , and working with multidisciplinary teams is a plus.** **Shift: ... experience, preferably in an oncology outpatient setting. Experience with prior authorization , insurance , and working with multidisciplinary teams is a plus.… 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
- 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
- Sanford Health (Sioux Falls, SD)
- …requirements and timeframes. Assist with coordination of activities related to insurance pre-certification/ authorization . Provide counseling to members or their ... provider specialty groups in coordinating care. Responsible for managing the authorization process for participating plan members ensuring that all services are… more
- Louisiana Department of State Civil Service (Jackson, LA)
- REGISTERED NURSE 1, 2, OR 3 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4778929) 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 (Jackson, LA)
- PRACTICAL NURSE --LICENSED, 1, 2, OR 3 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4778972) Apply PRACTICAL NURSE --LICENSED, 1, 2, OR ... 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
- Veterans Affairs, Veterans Health Administration (Tucson, AZ)
- Summary The Maternity and Fertility Care Coordinator (MFCC) Registered Nurse (RN) executes position responsibilities that demonstrate expert leadership, experience, ... Responsibilities The Maternity and Fertility Care Coordinator (MFCC) Registered Nurse (RN) executes position responsibilities that demonstrate expert leadership,… more
- Amergis (Oklahoma City, OK)
- …assigned responsibility for performing a full range of nursing assignments as a STI Nurse Educator & Rapid Start RN and perform nursing task at the full performance ... to others in completing routine nursing task and activities. The STI Nurse Educator & Rapid Start RN/LPN sexually transmitted infections (STI) assessment, treatment,… more
- Louisiana Department of State Civil Service (Angola, LA)
- PRACTICAL NURSE -LICENSED 1, 2, OR 3 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4778893) 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...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)
- REGISTERED NURSE 1, 2, OR 3 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4780542) 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
- Veterans Affairs, Veterans Health Administration (Richmond, VA)
- Summary This Registered Nurse - SCI/D Case Manager (Unit 1W) position is located at the Richmond Veterans Affairs Medical Center in Richmond, Virginia. Please learn ... more about the position below, along with the duties. Responsibilities The Registered Nurse - SCI/D Case Manager (Unit 1W) is directly responsible to the designated… more
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