- 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
- Actalent (Baton Rouge, LA)
- Job Title: Prior Authorization NurseJob Description The Prior Authorization Nurse plays a critical role in analyzing prior authorization ... assess the medical necessity of member care. + Escalate prior authorization requests to Medical Directors as...years of related experience. + LPN - Licensed Practical Nurse - State Licensure required. + RN license required… 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
- Actalent (St. Louis, MO)
- Remote Clinical Review Nurse - Prior Authorization Location: Must be located in Central or Eastern time zones Employment Type: Full‑Time About the Role We ... are seeking an experienced Registered Nurse to join our team within a leading Managed...fast‑paced environment. Key Responsibilities + Conduct clinical reviews of prior authorization requests for medical services, procedures,… 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
- Humana (Madison, WI)
- …Word, Excel, and Outlook. + At least 3-years' experience with prior authorization / utilization management. + Previous leadership experience. **Preferred ... first** Ready to make a real impact? As our Pre- Authorization Nursing Supervisor, you'll lead the way in helping...team to keep things running smoothly. If you're a nurse who loves collaborating, problem-solving, and making a difference,… more
- Mille Lacs Health System (Onamia, MN)
- …MN, USA | Hourly | 20.61-30.92 per hour | Full Time Summary The Prior Authorization Specialist works under the direction of the Health Information Manager. ... end of the bullet point. + Receive and monitor prior authorization requests in accordance with MLHS...Experience + Medical Assistant (MA) certification or Licensed Practical Nurse (LPN) licensure in the State of Minnesota +… more
- Humana (Dover, DE)
- …of our caring community and help us put health first** Humana is seeking a Prior Authorization RN to join the Wisconsin Medicaid Market (iCare) team. This ... position reviews the clinical appropriateness of prior authorization (PA) requests and ensures that...an impact** **Required Qualifications** + Licensed as a Registered Nurse in the State of Wisconsin, including compact license.… more
- Hartford HealthCare (Manchester, CT)
- …are prevented. 7. Verifies insurance policy benefit information and obtains Authorization /Precertification prior to the patient's visit, scheduled surgery, ... Hospital, a 102-bed facility, a large multispecialty provider group and visiting nurse services. The Greater Manchester Region serves a region of 300,000 people… 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
- Louisiana Department of State Civil Service (Angola, LA)
- PRACTICAL NURSE -LICENSED 1, 2, OR 3 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4778893) Apply PRACTICAL NURSE -LICENSED 1, 2, OR 3 ... 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… 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 (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 (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 (Angie, LA)
- PRACTICAL NURSE - LICENSED 1, 2, or 3 (WAE)...license, or DD-214 must be verified by official documentation prior to hire. + Any qualifying experience that is ... Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4777549) Apply PRACTICAL NURSE - LICENSED 1, 2, or 3 (WAE) Salary $2,784.00 - $5,009.00… 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/5176419) Apply REGISTERED NURSE 1, 2, or 3 Salary Depends on ... 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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