- UCLA Health (Los Angeles, CA)
- …This position is responsible for reviewing and evaluating clinical documentation related to prior authorization requests for medical services. The UM Review ... efficient utilization of resources. Key Responsibilities: + Conducts clinical reviews of prior authorization requests to evaluate medical necessity and benefit… 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...Twitter and LinkedIn. **Brief summary of purpose:** The PA Nurse uses a multidisciplinary approach to review service requests… more
- 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 (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
- 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
- CVS Health (Baton Rouge, LA)
- …all with heart, each and every day. **Position Summary** The Utilization Management Nurse Consultant (UMNC) for Prior Authorization conducts high-acuity, ... supporting regulatory compliance and organizational goals. Key Responsibilities: * Perform prior authorization clinical reviews of acute admissions using… more
- AssistRx (Orlando, FL)
- …support programs. + Familiarity with PSP workflows: hub services, copay programs, prior authorization , benefits investigations, nurse support. + Strong ... treatment. Our suite of solutions-including iAssist(R), Hub Lite (TM) , Prior Authorization , Benefits Verification, Copay Support, specialty pharmacy… more
- CVS Health (Baton Rouge, LA)
- …Screening, Diagnostic, and Treatment (EPSDT) case managers, providers, and enrollees on prior authorization requests for services. The UM Coordinator will ... days of the scheduled appointment * Assists with problems on each prior authorization requests, including identification of new providers, notification to… more
- Hartford HealthCare (Farmington, CT)
- …on billing and authorization processes.* * *Assists with training of new prior authorization staff and other duties as assigned.* *At Hartford HealthCare, we ... based on eligibility.* *Job Summary: Under the direction of the Prebilling and Authorization Manager, the Authorization Specialist performs all duties related to… 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. ... Technician (or eligible), Registered Record Administrator (or eligible) or Licensed Practical Nurse (LPN) with a minimum of 5 years' experience in an appropriate… more
- MD Anderson Cancer Center (Houston, TX)
- …an Advanced Practice Registered Nurse from the Texas State Board of Nursing prior to 1/1/2003. * : Graduate education and related Texas Board of Nursing ... Pract. Upon Hire or * Required: APNPAdv Pract Nurse /Prescriptive Upon Hire or * Required: Related authorization... Nurse /Prescriptive Upon Hire or * Required: Related authorization must be consistent with clinical practice area and… more
- US Tech Solutions (GA)
- …from distractions. You will provide processing and communication of specialty medication prior authorization (PA) requests reviewed by the Specialty Medical ... Prior Authorization department. Reporting to the Pharmacy Operations Manager, you...following policy and procedure. + Provide on-call after hours nurse availability for urgent PA requests. + Provide internal… 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
- Commonwealth of Pennsylvania (PA)
- …illness, or developmental disability. Special Requirements: + This position requires active authorization to practice as a Registered Nurse in Pennsylvania. + ... box. *Eligibility rules apply. 01 Do you possess active authorization to practice as a Registered Nurse ...Unofficial transcripts are acceptable.? You must attach your transcript(s) prior to the submission of your application by using… more
- Louisiana Department of State Civil Service (St. Gabriel, LA)
- REGISTERED NURSE 1, 2, OR 3 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4776430) 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....employee may be required to serve a trial detail prior to being permanently promoted. + TEMPORARY JOB APPOINTMENT:… 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 ... employee may be required to serve a trial detail prior to being permanently promoted + TEMPORARY JOB APPOINTMENT:...has a Special Entrance Rate at each level Registered Nurse 1 has an SER of $29.84 per hour.… more
- Louisiana Department of State Civil Service (Kinder, LA)
- PRACTICAL NURSE --LICENSED, 1, 2, OR 3 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4780632) Apply PRACTICAL NURSE --LICENSED, 1, 2, OR ... employee may be required to serve a trial detail prior to being permanently promoted. + TEMPORARY JOB APPOINTMENT:...has a Special Entrance Rate at each level Practical Nurse -Licensed 1 has an SER of $19.48 per hour.… more
- Louisiana Department of State Civil Service (Angie, LA)
- REGISTERED NURSE 1, 2 or 3 (WAE) Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4777670) Apply REGISTERED NURSE 1, 2 or 3 (WAE) Salary ... degree, certificate, special license, or DD-214 must be verified by official documentation prior to hire. + Any qualifying experience that is based on college… more
- Louisiana Department of State Civil Service (Angola, LA)
- REGISTERED NURSE SUPERVISOR A Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/5170465) Apply REGISTERED NURSE SUPERVISOR A Salary ... mission. Minimum Qualifications Possession of a current Louisiana Registered Nurse license or a temporary permit or multi-state license...promotion may be required to serve a trial detail prior to being permanently promoted. + This posting may… more
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