• Precertification Nurse

    NJM Insurance (Trenton, NJ)
    …appropriate and causally related. + Evaluate requests for precertification /preauthorization/prescreen to determine if treatment is medically necessary, clinically ... business process improvements. Required Skills & Experience: + Actively licensed registered Nurse in New Jersey and Connecticut, Delaware, Maryland, New York or… more
    NJM Insurance (11/06/24)
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  • Registered Nurse

    WestCare Foundation (Marathon, FL)
    Registered Nurse Job Details Job Location Marathon - 3000 41st Ocean 1 - Marathon, FL Education Level 2 Year Degree Salary Range $37.45 - $37.45 Hourly Travel ... Percentage Negligible Job Category Nurse Description Provides professional nursing care to clients who...clinic. Example Job Duties: + Determines need for insurance precertification upon admission and implements process in accordance with… more
    WestCare Foundation (09/27/24)
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  • Utilization Management Nurse Consultant

    CVS Health (Phoenix, AZ)
    …clinical practice guidelines for treatment and services both inpatient and outpatient requiring precertification . The majority of the time is spent at a desk and on ... the telephone collecting & reviewing clinical information from providers. Precertification nurses use specific criteria to authorize procedures/services or initiate… more
    CVS Health (11/07/24)
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  • Utilization Management Nurse - US Air Force

    Katmai (Usaf Academy, CO)
    …those enrollees identified as having the need for inpatient/outpatient precertification . **ESSENTIAL DUTIES &** **RESPONSIBILITIES** + Review precertification ... Registered Nurses (RN) licensed in Colorado, be able to practice using a nurse compact state license or have a license from any United States jurisdiction… more
    Katmai (10/19/24)
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  • Registered Nurse

    G-TECH Services, Inc. (Detroit, MI)
    …by providers, facilities and members. Responsible for the review of precertification , admissions approvals, telephone triage, and/or benefit interpretation. May be ... insurance plan experience or managed care environment highly preferred. Registered Nurse with current unrestricted Michigan Registered Nurse license required.… more
    G-TECH Services, Inc. (11/02/24)
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  • Registered Nurse

    Weill Cornell Medical College (New York, NY)
    Title: Registered Nurse Location: Lower East Side Org Unit: Obstetrics and Gynecology Work Days: Monday-Friday Weekly Hours: 35.00 Exemption Status: Exempt Salary ... policies and procedures. + May be responsible for the precertification and preauthorization of prescriptions. + When needed, records...more years of related work experience as a Registered Nurse . Extensive experience as a Registered Nurse more
    Weill Cornell Medical College (10/26/24)
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  • Nurse Practitioner - Genitourinary (GU)…

    Weill Cornell Medical College (New York, NY)
    Title: Nurse Practitioner - Genitourinary (GU) Oncology Location: Upper East Side Org Unit: Hematology and Medical Oncology Work Days: Exemption Status: Exempt ... latest breakthroughs in medicine. In collaboration with an attending physician the Nurse Practitioner is responsible for the coordination and direct care of patients… more
    Weill Cornell Medical College (09/06/24)
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  • Utilization Managment Nurse Consultant

    CVS Health (Sacramento, CA)
    …more personal, convenient and affordable. **Position Summary** This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any ... travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate,...in PST preferred + 1+ years experience in either Precertification or Utilization Review highly preferred + 1+ years… more
    CVS Health (11/07/24)
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  • Nurse Tech - Womens/Post Sur

    LifePoint Health (Athens, TN)
    Starr Regional Medical Center is currently seeking talent to fill the position of Nurse Tech for our Women's Services Department. This job is permanent, full time. ... and determine placement. * Verifies insurance benefits and obtains precertification /authorization as necessary. Determines and accepts required payments, including… more
    LifePoint Health (10/25/24)
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  • Nurse Medical Management Sr

    Elevance Health (Tampa, FL)
    Job Description ** Nurse Medical Management Sr.** **Preferred Location** : Florida. **This position will work 100% remote (with the exception of team meetings which ... will live within 50 miles of one of our Elevance Health PulsePoint locations. ** Nurse Medical Management Sr.** Responsible to serves as team lead for nursing staff… more
    Elevance Health (11/02/24)
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  • Nurse Tech-PRN Women's Services

    LifePoint Health (Athens, TN)
    …* Verifies insurance benefits and obtains precertification /authorizationas necessary.Determinesand accepts required payments, including co-pays ... □ Preferred X Required Required Licenses[Tennessee, United States] Nursing Assistant Certified Nurse Aide Licensure in State of TNX Preferred □ Required Required… more
    LifePoint Health (10/11/24)
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  • Nurse Medical Management ll

    Elevance Health (Columbus, OH)
    …or 1-hour commute each way of a relevant Elevance Health location. The ** Nurse Medical Management ll** is responsible to collaborate with healthcare providers and ... Primary duties may include, but are not limited to: + Conducts precertification , continued stay review, care coordination, or discharge planning for appropriateness… more
    Elevance Health (11/02/24)
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  • Staff Nurse White House MA/LPN/RN

    Vanderbilt University Medical Center (White House, TN)
    …testing requisitions o Sends/receives and accurately routes referral and precertification information o Schedule's * 3. Patient/Family Education * Distributes ... area of work. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC-Licensed Practical Nurse - Tennessee **Work Experience:** Relevant Work Experience **Experience… more
    Vanderbilt University Medical Center (11/07/24)
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  • Nurse Case Manager I

    International Medical Group (Indianapolis, IN)
    …Document information and status in case management systems and document + Prepare precertification and/or case management reports as needed. + Use good judgment when ... as assigned. QUALIFICATIONS + Current and active Nursing license - Registered Nurse + Minimum two years acute hospital-based experience providing direct patient care… more
    International Medical Group (09/18/24)
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  • RN Registered Nurse - Utilization Review

    Ascension Health (Manhattan, KS)
    …departmental staff with issues related to coding, medical records/documentation, precertification , reimbursement and claim denials/appeals. + Assess and coordinate ... **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse credentialed from the Kansas Board of Nursing required. Education:… more
    Ascension Health (09/13/24)
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  • Registered Nurse -Triage Pediatrics…

    Weill Cornell Medical College (Brooklyn, NY)
    Title: Registered Nurse -Triage Pediatrics (Partially Remote) Brooklyn Location: Brooklyn Org Unit: Clinical Operations Work Days: Monday-Friday Exemption Status: ... protocol requirements, if applicable. + May be responsible for the precertification and preauthorization of prescriptions and for routing pended prescription refill… more
    Weill Cornell Medical College (08/27/24)
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  • Pleasant View Staff Nurse MA/LPN/RN

    Vanderbilt University Medical Center (Pleasant View, TN)
    …testing requisitions * Sends/receives and accurately routes referral and precertification information * Schedule's appointments * Handles physician correspondence * ... Communicates patient needs to MD/provider through accurate use of electronic health record task system. * Ensures cleanliness of exam room equipment, instruments; and keeps exam rooms adequately stocked. Restocks supplies as needed. Maintains an organized… more
    Vanderbilt University Medical Center (09/29/24)
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  • RN Admission Facilitator

    Trinity Health (Albany, NY)
    …and experience in rehabilitation. + Facilitation of benefit eligibility and precertification by payers prior to the rehabilitation admission. + Coordination of ... payer requirements + Assists in facilitation benefit eligibility and precertification + Maintains a thorough knowledge of rehabilitation settings, post-acute… more
    Trinity Health (11/08/24)
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  • Utilization Management Representative II

    Elevance Health (Tampa, FL)
    …and benefit eligibility; provides authorization for inpatient admission, outpatient precertification , prior authorization, and post service requests. + Obtains ... provider on referrals given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. + Processes incoming requests,… more
    Elevance Health (11/07/24)
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  • Senior Patient Service Specialist - Executive…

    Vanderbilt University Medical Center (Hingham, MA)
    …with outside facilities or providers. Facilitates required pre-authorization, precertification or predetermination for procedures or appointments. Provide guidance ... group of nurses, patient service specialists, physical therapists, advanced nurse practitioners, and many other health professionals to provide exceptional… more
    Vanderbilt University Medical Center (11/05/24)
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