• 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 - 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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  • Case Manager Registered Nurse

    Surgery Care Affiliates (Jacksonville, FL)
    …in areas of treatment plan, discount or per diem negotiations, precertification concurrent reviews and timely reports. + Determines tentative initial discharge ... in areas of treatment plan, discount or per diem negotiations, precertification concurrent reviews and timely reports. + Determines tentative initial discharge… more
    Surgery Care Affiliates (11/10/24)
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  • Nurse Practitioner - Urology

    Weill Cornell Medical College (New York, NY)
    Title: Nurse Practitioner - Urology Location: Upper East Side Org Unit: General Urology Clinical Operations Work Days: Monday-Friday Exemption Status: Exempt Salary ... urological health and science. In collaboration with an attending physician, the Nurse Practitioner is responsible for the coordination and direct care of patients… more
    Weill Cornell Medical College (11/26/24)
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  • Registered Nurse

    Weill Cornell Medical College (New York, NY)
    Title: Registered Nurse Location: Upper East Side Org Unit: Hemophilia Clinical Research Work Days: Weekly Hours: 35.00 Exemption Status: Exempt Salary Range: ... 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 (11/23/24)
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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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  • 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 (11/25/24)
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  • Nurse Medical Mgmt Sr

    Elevance Health (St. Louis, MO)
    ** Nurse Medical Management Sr.** At **Federal Health Products and Services - FHPS** , a proud member of the Elevance Health, Inc. family of companies, it's a ... pm (EST) with 10 am - 7 pm (EST) shift rotation twice a month.** The ** Nurse Medical Management Sr** is responsible for serving as team lead for nursing staff who… more
    Elevance Health (11/22/24)
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  • Registered Nurse RN - Utilization Review

    Ascension Health (Destin, FL)
    …departmental staff with issues related to coding, medical records/documentation, precertification , reimbursement and claim denials/appeals. + Assess and coordinate ... regulations. **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse credentialed from the Florida Board of Nursing obtained prior to… more
    Ascension Health (11/16/24)
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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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  • 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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  • Quality Management Nurse Associate LPN

    CVS Health (Austin, TX)
    …+ Managed care experience + Leadership experience + Utilization Management, Precertification or Quality Management experience **Education** High school diploma with ... LPN/LVN certification **Pay Range** The typical pay range for this role is: $22.40 - $58.40 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base… more
    CVS Health (11/23/24)
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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 (11/15/24)
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  • Utilization Management Representative I

    Elevance Health (Wallingford, CT)
    …**Utilization Management Representative I** is responsible for coordinating cases for precertification and prior authorization review. **How you will make an impact ... and benefit eligibility; provides authorization for inpatient admission, outpatient precertification , prior authorization, and post service requests. + Refers cases… more
    Elevance Health (11/20/24)
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  • Utilization Management Representative II

    Elevance Health (Topeka, KS)
    …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 (11/12/24)
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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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  • Specialist-Patient Placement LPN - NM Scheduling…

    Baptist Memorial (Oxford, MS)
    …resource consumption and reimbursement. + Precertifies patient care services that require precertification , as identified, in a timely, efficient manner, in order to ... performance improvement activities in order to maximize the patient placement/ precertification process. + Completes assigned goals. Requirements, Preferences and… more
    Baptist Memorial (10/05/24)
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