- University of Miami (Miami, FL)
- …CORE FUNCTIONS: + Adhere and perform timely prospective review for services requiring prior authorization as well as timely concurrent review for continuation of ... conducts initial, concurrent and retrospective chart reviews for clinical utilization and authorization . The Utilization Review Case Manager coordinates with the… more
- Hackensack Meridian Health (Paramus, NJ)
- …/Radiation Oncology services in the HMH Health care system. This pertains to Prior Authorization for Oncology services, as well as various specialized ... clinical data is submitted to substantiate the request for prior approvals for oncology services. **Responsibilities** A...in order to avoid technical denials for lack of prior authorization . Understand if payer rules governing… more
- University of Virginia (Charlottesville, VA)
- Provide billing and compliance support within the Division of Radiation Oncology to include; compliance and charge capture, referral/medical necessity, denial ... support to clinic and administrative personnel within the Division of Radiation Oncology . + Assures that all referrals are managed effectively and efficiently for… more
- University of Virginia (Charlottesville, VA)
- …Required tasks and database information, not completed during intake, are accurately completed prior to forwarding case . d. Exhibits a thorough working knowledge ... in the proper Epic system such as OpTime, Cupid, or Radiant. a. Scrubs case order for accuracy and completeness. Ensures diagnoses and procedure match. Review all… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …provides Utilization Management services to its clients. The Utilization Management Nurse - Prior Authorization performs medical necessity reviews on prior ... to ensure timely review of services and care. * Provides referrals to Case management, Disease Management, Appeals & Grievances, and Quality Departments as needed. *… more
- Hackensack Meridian Health (Hackensack, NJ)
- …of studies for feasibility and evaluates potential competition with other protocols prior to submitting study + Reviews study with principal investigator and/or ... consent + Educates study patients concerning informed consent procedures, HIPAA authorization + Documents study patient?s medical history including but not limited… more
- Beth Israel Lahey Health (Boston, MA)
- …for patients from referral/consultation to discharge /follow up. Assists with pre- authorization process. 2. Serves as contact and facilitator to receive consults ... of patient/family educational materials. Participates in patient rounds and case conferences. 5. Updates clinical knowledge and skills through consultation,… more
- Glens Falls Hospital (Glens Falls, NY)
- …appeal as necessary. Obtains retro-authorizations when denial is for lack of prior authorization , when allowed by payor. Works collaboratively with Finance ... is responsible for tracking, trending and appealing denials associated with the Oncology Service Line across all locations. *The Glens Falls Hospital Impact* **… more
- University of Washington (Seattle, WA)
- …to complete it within 30 days of hire. **DESIRED QUALIFICATIONS** + Knowledge of oncology practice and terminology. + Prior working experience at the UWMC, FHCC, ... Req #: 234315 Department: DEPARTMENT OF MEDICINE: HEMATOLOGY AND ONCOLOGY Posting Date: 05/17/2024 Closing Info: Open Until Filled Salary: $4,583 - $5,230 per month… more
- Fairview Health Services (Minneapolis, MN)
- …to improving patient outcomes. **Responsibilities Job Description** Initiate calls to receive prior authorization information for services prior to service ... weeks)** on the **day shift** with **as needed rotating weekends** ! As an Oncology Care Coordinator, you will play a pivotal role in providing comprehensive support… more
- University of Washington (Seattle, WA)
- Req #: 234827 Department: DEPARTMENT OF MEDICINE: HEMATOLOGY & ONCOLOGY Appointing Department Web Address: https://hemonc.uw.edu/ Job Location Detail: Fred ... treatment of cancer in the world. **The Division of Hematology and Oncology has an outstanding opportunity for a** **_Temporary_** **Research Study Assistant.** This… more
- Northern Light Health (Portland, ME)
- …Office Patient Service representatives to verify benefits and to obtain required prior authorization (s). + Identify potential barriers to care and collaborates ... referrals from patients, families, and referral sources for all newly diagnosed oncology , benign hematology and infusion therapy patients seeking to come to the… more
- Providence (WA)
- …of Outpatient Care) + Utilization Management Experience (EX. Concurrent Review, Prior Authorization , Medical Audits, Appeals or Delegation) + Experience ... Coordinator RN, Medicare / Medicaid who will:** + Provide care coordination, case management and care management services to Providence Health Plans(PHP) members +… more
- MD Anderson Cancer Center (Houston, TX)
- …to comply with institutional standards, initiatives, and guidelines (ABN's, prior authorization requirements, reimbursement optimization, formulary management, ... learning experiences. * Effectively precepts other trainee-required experiences including oncology forum, research projects, grand rounds, MUEs, etc. * Collaborates… more
- LifePoint Health (Martinsville, VA)
- …number(s).. . Contacts physician's office, when necessary, to resolve any issues regarding prior authorization or referral forms. . Communicates all exam prep ... a variety of the Hospital's patient information related systems, assesses each case related concern and resolves issues with regards to appointments, financial… more
- Hartford HealthCare (Bridgeport, CT)
- …communication as required, to Agency personnel and other reimbursement sources. * Obtains prior authorization for services when indicated by calling payers and ... and schools and colleges. We offer a variety of specialists, including oncology , women's health, sports medicine, physical therapy, occupational therapy and speech… more
- Dignity Health (San Francisco, CA)
- …the human touch. Strategies and business development are centered on Oncology Services Cardiac Services and Orthopedics. **Responsibilities** This position manages ... all the case management clerical duties for the workers compensation program...patient registration and billing. Performs tasks associated with treatment authorization and referral services. This position assists with daily… more
- University of Florida (Gainesville, FL)
- …composed of twenty-One residents, and three fellowships (Endovascular, Functional and Neuro- Oncology ) composed of 4 fellows. Maintain accurate and thorough academic ... Manage and ensure timely completion of rotation and curriculum evaluations, residency case logs and entry into electronic databases. Track educational activities of… more
- Option Care Health (Cincinnati, OH)
- …Care and externally with customers (ex. medical director, head of case management, executive c-suite individuals). **Travel Requirements** **: (if** **required)** + ... at least 4 years of pharmaceutical or healthcare sales experience. + Prior experience selling strategic solutions (specialty products and/or services) to hospitals,… more
- Hackensack Meridian Health (Hackensack, NJ)
- …of studies for feasibility and evaluates potential competition with other protocols prior to submitting study + Reviews study with principal investigator and/or ... consent + Educates study patients concerning informed consent procedures, HIPAA authorization + Documents study patient?s medical history including but not limited… more