- A-Line Staffing Solutions (New York, NY)
- …Case Management, InterQual, Medicare, Medicaid, CMS Guidelines, Utilization Review, Utilization Management, Registered Nurse , MCO, RN , Nurse , Managed ... Case Management, InterQual, Medicare, Medicaid, CMS Guidelines, Utilization Review, Utilization Management, Registered Nurse , MCO, RN , Nurse , Managed… more
- US Tech Solutions, Inc. (Columbia, SC)
- …role: The nurse would work remotely from their home reviewing authorization requests from providers for home health visits or DME (durable medical equipment). ... equipment to be prepared. . The position is fully remote after that. . Please list out the top...the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse … more
- Actalent (Houston, TX)
- Prior Authorization Registered Nurse Remote (Must reside in Texas) Job Description We are currently seeking a highly skilled and motivated Remote ... RN ) to join our dynamic team. As a Remote Clinical Review Nurse /Concurrent Review Nurse...in Texas. + 2 years of clinical experience with prior authorization and/or utilization review. + Strong… more
- 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 ... an exciting opportunity for an Utilization Review Case Manager to work remote . The incumbent conducts initial, concurrent and retrospective chart reviews for… more
- Molina Healthcare (Phoenix, AZ)
- **_For this position we are seeking a ( RN ) Registered Nurse with previous experience in Hospital Acute Care, Concurrent Review/ Utilization Review / ... for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of… more
- Sharecare, Inc. (Columbus, OH)
- …finding alternative care options or assist member in working with payer to complete prior authorization or appeals process, when necessary. + Abide by Clinical ... in influencing patient and provider outcomes **Qualifications:** + Current multi-state/compact Registered Nurse licensure in state of residence is required,… more
- MD Anderson Cancer Center (Houston, TX)
- …area and patient population. **EXPERIENCE** Preferred: Experience as Advanced Practice Registered Nurse . Prior Medical Oncology experience. **LICENSURE ... for applicants who obtained recognition as an Advanced Practice Registered Nurse from the Texas State Board...Nurse from the Texas State Board of Nursing prior to 1/1/2003. Graduate education and related Texas Board… more
- Veterans Affairs, Veterans Health Administration (Jacksonville, NC)
- …Scope of Assigned Duties: The Nurse II Maternity Care Coordinator (MCC) Registered Nurse ( RN ) is responsible for providing competent, evidence-based care ... The Nurse III Maternity Care Coordinator (MCC) Registered Nurse ( RN ) executes position...have opportunity to become registered as a nurse with a state licensing board prior … more
- MD Anderson Cancer Center (Houston, TX)
- …Nursing Practice. May be waived for applicants who obtained recognition as an Advanced Practice Registered Nurse from the Texas State Board of Nursing prior ... Center staff to perform peer-to-peer requests to obtain financial authorization for procedures/tests, in conjunction with faculty Triage internal...Board of Nursing to function as an Advanced Practice Registered Nurse (APRN or ACNP or ACNPC… more
- MD Anderson Cancer Center (Houston, TX)
- …Nursing Practice. May be waived for applicants who obtained recognition as an Advanced Practice Registered Nurse from the Texas State Board of Nursing prior ... 1/1/2003. Graduate education and related Texas Board of Nursing authorization must be consistent with clinical practice area and...Board of Nursing to function as an Advanced Practice Registered Nurse (APRN or ACNP or ACNPC… more
- Molina Healthcare (Charleston, SC)
- …**_For this position we are seeking a ( RN ) Registered Nurse with previous experience in Prior Authorizations, Utilization Review / Utilization Management ... for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of… more
- Molina Healthcare (Riverside, CA)
- …**JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse ( RN ), Licensed Vocational Nurse (LVN) ... medical clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ), Licensed Vocational Nurse … more
- Providence (Vancouver, WA)
- …in the collaboration and management of patient care + Current unencumbered Registered Nurse License in state of residency **Preferred qualifications for ... + Bachelor's Degree in Nursing or Health Education + Upon Hire: Current unencumbered Registered Nurse License in Oregon + Within six months of hire date:… more
- Molina Healthcare (New York, NY)
- ….** **We are looking for a RN Care Review Clinician with Prior Authorization experience. Candidates with Utilization Management (UM) and MLTC/LTC experience ... for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of… more
- Molina Healthcare (Florence, KY)
- **JOB DESCRIPTION** **Opportunity for a US licensed RN to do prior authorization reviews with Molina Healthcare. Applicants call across the contiguous US ... for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of… more
- Molina Healthcare (Los Angeles, CA)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina… more
- SSM Health (WI)
- …Illinois Department of Financial and Professional Regulation (IDFPR) State of Work Location: Missouri + Registered Nurse ( RN ) Issued by Compact State + Or + ... **It's more than a career, it's a calling** WI- REMOTE **Worker Type:** Regular **Job Highlights:** + **Department:**...Registered Nurse ( RN ) - Missouri Division of Professional… more
- CVS Health (Baton Rouge, LA)
- …clinical experience + 1+ year(s) of utilization management, concurrent review and/or prior authorization experience + 5+ years of equipment experience including ... environment + Remote work experience **Education** + Associate's nursing degree ( RN ) minimum required + Bachelor's degree preferred **Pay Range** The typical pay… more
- Molina Healthcare (San Jose, CA)
- **_INPATIENT REVIEW : REGISTERED NURSE_** **_For this position we are seeking a ( RN ) Registered Nurse with previous experience in Hospital Acute Care, ... financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed. + Processes… more
- Carle (Urbana, IL)
- …Qualifications: EDUCATIONAL REQUIREMENTS College Diploma Nursing CERTIFICATION & LICENSURE REQUIREMENTS Registered Nurse ( RN ) Illinois and Basic Life ... Save Save Apply Now Position Summary: *Potential to work remote after orientation*The Ambulatory Nurse utilizes a...EPIC + Assist with RAMS- Rapid assessment clinic + Prior authorization for psych medications + Injections… more
