• Altru Health (Emerado, ND)
    …90 days of start date | Learning Management System Notes: Temporary RN license accepted prior to start. ND RN Graduate Work Authorization considered prior to ... Forks, ND 58201 Pay Range: $32.19 - $48.28 Summary: The Registered Nurse provides direct nursing care in accordance with established policies, procedures and… more
    JobGet (11/16/24)
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  • Altru Health (Emerado, ND)
    …90 days of start date | Learning Management System Notes: Temporary RN license accepted prior to start. ND RN Graduate Work Authorization considered prior to ... assistance * A supportive and collaborative work environment The Registered Nurse provides direct nursing care in accordance with established policies, procedures… more
    JobGet (11/14/24)
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  • Prior Authorization Nurse

    Medical Mutual of Ohio (OH)
    …perform pre-employment substance abuse and nicotine testing._ **Title:** _Prior Authorization Nurse Reviewer_ **Location:** _Ohio_ **Requisition ID:** _2400509_ ... Board. Bachelor's degree preferred. *3 years' experience as a Registered Nurse with a combination of clinical and utilization/case management experience, preferably… more
    Medical Mutual of Ohio (11/05/24)
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  • Nurse Clinician: Prior

    Molina Healthcare (San Francisco, 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 (10/17/24)
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  • Pre- Authorization Registered Nurse

    Humana (Oklahoma City, OK)
    …Spouse looking for an internship that supports the goal to put health first? The Prior Authorization , Registered Nurse , RN, Intern will review prior ... a variety of professional onsite, field, or remote based opportunities. The Prior Authorization , Registered Nurse , RN, Intern will utilize Humana's Medicaid… more
    Humana (11/15/24)
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  • Prior Authorization Licensed…

    US Tech Solutions (May, OK)
    …other clinical colleagues, healthcare professionals and members. + * Follow all prior authorization procedures to guarantee an accurate process on each ... policy and procedure. + * Provide on-call after hours nurse availability for urgent PA requests. + * Provide... prior authorization . + * Train and mentor... prior authorization . + * Train and mentor representatives on the… more
    US Tech Solutions (10/18/24)
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  • Clinical Review Nurse - Prior

    Centene Corporation (Baton Rouge, LA)
    …serves our Louisiana Healthcare Connection population. **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service ... interdepartmental teams, to assess medical necessity of care of member + Escalates prior authorization requests to Medical Directors as appropriate to determine… more
    Centene Corporation (11/17/24)
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  • Registered Nurse

    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...indicated by staffing and business needs. **Duties:** + **Registered Nurse with current license in LA state of employment.… more
    US Tech Solutions (10/18/24)
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  • Pre- Authorization Nurse

    Humana (Atlanta, GA)
    **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 approves services or forward requests to the appropriate stakeholder. The Pre- Authorization Nurse 2 + Completes medical necessity and level of care reviews… more
    Humana (11/16/24)
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  • REMOTE Prior Authorization

    TEKsystems (Rochester, NY)
    Description: The Pharmacy Prior Authorization Technician performs functions as permitted by law including the initial level processing and review of prior ... This position provides leadership and expertise in the intake area of the prior authorization process for medications processed either through the pharmacy or… more
    TEKsystems (11/07/24)
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  • CMA, Prior Authorization Specialist…

    Atlantic Health System (Morristown, NJ)
    Overview: We are seeking a skilled Medical Prior Authorization Specialist to join our team. The ideal candidate will be responsible for obtaining prior ... entire authorization process. Responsibilities: 1. Initiate and manage the prior authorization process for all obstetrical patients and gynecological… more
    Atlantic Health System (10/01/24)
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  • Prior Authorization Specialist…

    Select Medical (West Orange, NJ)
    **Overview** **Kessler Institute for Rehabilitation** West Orange, NJ ** Prior Authorization Specialist/Payor Relations Specialist ( RN , LPN )** **This is an** ... for the care and services they need, as a Prior Authorization Specialist.** **Responsibilities** As a **...admission to the acute inpatient rehabilitation hospital. + Registered Nurse (RN) or Licensed Practical Nurse (LPN)… more
    Select Medical (09/07/24)
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  • Prior Authorization Rep Sr,…

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    *SUMMARY:* We are currently seeking a* Prior Authorization Representative Senior*to join our*Financial Securing*team. This full-time role will primarily work ... remotely (SHIFT: Days M-F). *Purpose of this position:*The Prior Authorization Specialist plays a key role in the patient financial experience by coordinating… more
    Minnesota Visiting Nurse Agency (11/09/24)
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  • LVN or RN Clinician, Prior

    Molina Healthcare (WI)
    …benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina ... we are seeking a LVN / LPN or RN Nurse with previous experience in Concurrent Review/_** **_Utilization Review...+ Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. +… more
    Molina Healthcare (11/09/24)
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  • Prior Authorization Specialist -…

    Select Medical (St. Charles, MO)
    **Overview** **Select Specialty Hospitals - St Louis** **Critical Illness Recovery Hospital** ** Prior Authorization Specialist / Payor Relations Specialist ( RN ... Payor Relations Specialist, you will manage the pre-certification and prior authorization of referrals scheduled for admission...in third party reimbursement. + Must be a Registered Nurse (RN) or Licensed Practical Nurse (LPN).… more
    Select Medical (11/09/24)
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  • Prior Authorization Specialist

    Select Medical (Peoria, AZ)
    …A joint venture with Select Medical & Banner Health Phoenix, Arionza ** Prior Authorization Specialist / Payor Relations Specialist** **Remote position - ... and independent judgment, the Payor Relations Specialist manages the pre-certification and prior authorization of referrals scheduled for admission to the Acute… more
    Select Medical (11/01/24)
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  • Associate Manager - Duals Utilization Management…

    CVS Health (Springfield, IL)
    …the needs of the department + 3+ years inpatient clinical experience as a Registered Nurse + 3+ years of Managed Care experience + 1+ years of Utilization Management ... experience + 1+ year Leadership experience (formal or informal roles) + Travel Required up to 5% for meetings/audits + 1+ years of MS office suites experience **Preferred Qualifications:** + Experience with MedCompass + Medicaid/Medicare/Duals experience +… more
    CVS Health (10/26/24)
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  • Coordinator- Authorization - ME Case…

    Baptist Memorial (Memphis, TN)
    …strategy. Specifically the managed care techniques the Coordinator uses focuses on prior authorization for services using evidence based criteria. Areas of ... Summary The Authorization Coordinator is responsible for facilitating information documentation...payer with patient access + Communicate with Utilization Review Nurse + Works assigned queues in the electronic medical… more
    Baptist Memorial (10/08/24)
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  • Registered Nurse Clinician, Prior

    Molina Healthcare (IA)
    …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 REGISTERED NURSE with previous experience in Concurrent Review/_** **_Utilization...+ Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. +… more
    Molina Healthcare (11/16/24)
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  • Palliative Revenue Cycle Authorization

    Gentiva (Mooresville, NC)
    …care for everyone, so we offer ongoing professional training, lower nurse -to-patient ratios, and comprehensive benefits for eligible employees. Here, you'll join ... lives every day. **Overview** We are looking for a **Palliative Revenue Cycle Authorization Specialist** to join our team. This position will directly report to the… more
    Gentiva (11/12/24)
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