Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote Prior Authorization Clinician II (RN/LVN)

LanceSoft

LanceSoft is seeking a Healthcare - Care Review Clinician II for a remote role in the United States. The position involves medical necessity reviews and prior authorization work for outpatient services, with training and after-training Saturday shifts.

Requirements include 3+ years in health plan or IPA prior authorization and a CA RN or LVN license. Travel to client offices or hospitals may be required as state plans vary.

#J-18808-Ljbffr
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Remote Prior Authorization Clinician II (RN/LVN) in United States vacancy
  •  ...Care Review Clinician II | Remote | Contract Business & Care Management...  ...years of clinical practice and prior inpatient and outpatient...  ...services. Active, unrestricted RN, LVN or LPN state nursing...  ...concurrent reviews and prior authorizations, assessing eligibility,... 
    Remote work
    Weekly pay
    Contract work
    Work at office
    Immediate start

    Walker Healthforce, Inc.

    United States
    3 hours ago
  •  ...Tittle: Healthcare - Care Review Clinician II Location: Remote Pay Range: $45.37 - $47.37 Duration...  ...clinical review or services requiring prior authorization Must Have Requirements: 3+...  ...review for OUTPATIENT. CA RN OR LVN license Knowledge/Skills/Abilities... 
    Remote work
    Permanent employment
    Full time
    Apprenticeship
    Local area
    Shift work

    Lancesoft

    Long Beach, CA
    1 day ago
  •  ...WellSense Health Plan is seeking a Prior Authorization Clinician for a fully remote role in the United States. You will review inpatient and outpatient requests...  ...care for members. The position requires an active RN license (NH or compact with NH) and prior... 
    Remote work

    Well Sense Health Plan

    United States
    3 days ago
  •  ...WellSense Health Plan is seeking a Prior Authorization Clinician to review proposed hospitalization, home...  ...appropriate care for members. The role requires RN licensure in NH or a compact state, 2+...  ...care knowledge. This is a fully remote position with potential travel to the... 
    Remote work
    Work at office

    Well Sense Health Plan

    Boston, MA
    3 days ago
  • $49.42k - $107.1k

     ...compact license. The Care Review Clinician will provide prior authorization for behavioral health services for the...  ...work schedule. This is a remote position. Home office with internet...  ...experience. • Registered Nurse (RN). License must be active and unrestricted... 
    Remote work
    Full time
    Work at office
    Home office
    Monday to Friday

    Molina Healthcare

    Remote
    14 days ago
  •  ...Medication Therapy Management (MTM) Clinician is responsible for providing...  ...Education Active Florida Registered (RN, LPN, NP) Requires three (3) years prior experience working in a health...  ...business General knowledge of Prior authorization criteria and pharmacy claims... 
    Full time
    Work at office

    SOLIS Health Plans

    Tallahassee, FL
    5 days ago
  •  ...and talented Registered Nurse Clinician to join our busy, fast paced...  ...reports as neededObtains prior authorization for medications as requiredWorks...  ...experience preferredActive RN LicenseCertification in...  ...Minneapolis with rotation to remote clinics as business dictatesThe... 
    Remote work
    Full time
    Temporary work
    Work at office
    Monday to Friday

    Twin Cities Spine Center

    Minneapolis, MN
    4 days ago
  • $30.37 - $59.21 per hour

    RN- Care Review Clinician- UM/Discharge Planning (Remote- CA License Req) CA, United States and 5 more Trending Job Description JOB DESCRIPTION Job Summary...  .../or procedures. Conducts reviews to determine prior authorization/financial responsibility for Molina and its... 
    Remote job
    Hourly pay
    Full time
    Work experience placement
    Work at office

    Molina Healthcare, Inc.

    Sacramento, CA
    3 days ago
  • $45 per hour

    Utilization Management Nurse Coordinator(RN or LVN) needed for a temp 6+ month, remote contract opportunity with Yoh'...  ...Coordinator reviews outpatient authorization requests, assesses medical necessity...  ...in Utilization Management, Prior Authorization, Case Management, or... 
    Remote work
    Contract work
    Temporary work
    Monday to Friday
    Weekend work

    Yoh

    Columbus, OH
    1 day ago
  •  ...Cambia Health is seeking an Appeals Clinician I to work remotely from home within Oregon, Washington, Idaho or Utah. You will apply nursing expertise...  ...role requires a Bachelor's Degree in Nursing and an active RN license in one of the eligible states, plus 3 years of... 
    Remote work
    Work from home

    Cambia Health

    Salem, OR
    3 days ago
  •  ...Cambia Health is seeking an Appeals Clinician I to work from home across Oregon, Washington, Idaho or Utah. You will apply nursing expertise...  ...and ongoing education of non-clinical staff. BSN and an active RN license with 3 years of clinical experience are required.J-18808... 
    Remote work
    Work from home

    Cambia Health

    Coeur D Alene, ID
    3 days ago
  • $32.4 - $44.55 per hour

     ...RN/LPN - Family Medicine - Windsor - Hybrid (On-Site Training)Christie Clinic's...  ...schedule of 3 days in office and 2 days remote following the successful completion of...  ...injections.Send prescription refills.Obtain prior authorizations for medications, testing, procedures,... 
    Remote work
    Full time
    Work at office
    Monday to Friday
    Flexible hours
    Night shift
    Weekend work

    Christie Clinic

    Champaign, IL
    4 days ago
  •  ...BlueCross BlueShield of South Carolina is seeking a Remote RN Medical Reviewer II to perform medical reviews using clinical documentation and established guidelines. You will review home health and hospice documentation, determine medical necessity, and support claims... 
    Remote work
    Work from home

    Southcarolinablues

    South Carolina
    1 day ago
  • Connect America is seeking a Remote Care Nurse II to deliver high-quality nursing care to patients in a remote setting across the United States...  ...optimize outcomes via telehealth. The ideal candidate has an RN license in the U.S., experience with telehealth and EHRs, and... 
    Remote job

    100Plus

    New York, NY
    3 days ago
  • $27.61 - $53.83 per hour

     ...appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.Conduct reviews to determine prior authorization/financial responsibility for Molina and its members.Process requests within required timelines.Refer appropriate cases to... 
    Hourly pay
    Contract work
    Work experience placement
    Work at office

    Credenza Health

    Long Beach, CA
    5 days ago
  •  ...Orlando Health, Inc. is seeking a CDE II, RN for remote work in Florida. The role requires concurrent review of clinical documentation, coordination with coding/HIM/UR, and documentation of findings to accurately reflect patient acuity and care level. The ideal candidate... 
    Remote work

    Orlando Health

    United States
    2 days ago
  • Astrana Health, Inc. is seeking a Case Manager II (RN or LVN) in Monterey Park, CA to manage a complex caseload across acute inpatient and...  ...and health plans, and the ability to work in a hybrid onsite/remote schedule. 2+ years of case management experience is preferred.... 
    Remote work

    Astrana Health, Inc.

    Monterey Park, CA
    3 days ago
  •  ...CS506 - Behavioral Health Clinician II - Full Time - Exempt972 Mission Street - San Francisco, CA 94103OverviewSalary Range $85,030.00 -...  ...and the need for consistent in-person engagement with clients, remote work or work-from-home arrangements are not available for this... 
    Remote work
    Permanent employment
    Full time
    Interim role
    Immediate start
    Work from home

    Episcopal Community Services Of San Francisco

    San Francisco, CA
    1 day ago
  •  ...Licensed Vocational Nurse II (LVN II) The Licensed Vocational Nurse II (LVN II) is...  ...skills to assist the Registered Nurse (RN) or Medical Provider. The LVN II utilizes...  ...and sorting in-coming faxes, obtaining prior authorizations. Enters charges into the system in an... 
    Full time

    University of Southern California (USC)

    Los Angeles, CA
    2 days ago
  • $55.53 - $85.8 per hour

     ...Description The Care Manager (RN) utilizes clinical...  ...includes reviewing clinician assessments and...  ...appropriate insurance authorizations are in place. Assists with...  ...systems Care Manager II (RN) Bachelor's or Master...  ...53 - $85.80/ hourly Remote or Onsite Onsite Job... 
    Remote work
    Hourly pay
    Daily paid
    Local area
    Shift work

    Hoag Health System

    Irvine, CA
    4 days ago
  • $75k - $85k

     ...coordinate with hospitals, physicians, and facilities to ensure smooth placements. This full-time, home-based role requires an LPN/LVN or RN or therapist with valid license, 2+ years in long-term care, and strong communication; benefits begin on first day of month. The... 
    Remote work
    Full time
    Work from home

    Fundamental Administrative Services, LLC

    Denton, TX
    1 day ago
  •  ...seeking a Pharmacy Technician II for the Patient Assistance Program...  ...on-site pharmacy duties with remote support to optimize patient...  ...position emphasizes coordinating prior authorizations, patient education, and collaboration with clinicians and pharmacists to facilitate... 
    Remote work

    Duke

    Durham, NC
    2 days ago
  •  ...Fully remote position supporting patients during Annual Wellness Visits. Requires strong clinical judgment, documentation skills...  ...Medicare, CMS, and HIPAA. What We're Looking For: Active RN or LPN/LVN compact license and 3+ years of clinical experience.... 
    Remote work
    Part time
    Flexible hours

    Care Talk Health

    United States
    2 days ago
  • $30.16 - $47.01 per hour

    LVN II - CVTI Clinic - Full Time 8 Hour Days (Non-Exempt) (Non-Union) Los Angeles, CA...  ...skills to assist the Registered Nurse (RN) or Medical Provider. The LVN II utilizes...  ...and sorting in-coming faxes, obtaining prior authorizations. Enters charges into the system in an... 
    Hourly pay
    Full time
    Work experience placement
    Local area

    Keck Medicine of USC

    Los Angeles, CA
    14 hours ago
  •  ...Elevance Health seeks a Nurse Case Manager II (RN) to manage care for members with complex and chronic conditions. This 100% telephonic role requires multi-state licensure and ongoing coordination with care teams. The position supports a virtual-first work model with... 
    Remote work

    Elevance Health

    United States
    3 days ago
  •  ...Goldsmith Orthodontics - Clear Smiles is seeking an Orthodontic Clinician II to join our growing team. You will assist in placing and...  ...of an Orthodontist. You will educate patients on care and remote monitoring, review charts, and perform lab work while maintaining... 
    Remote work

    Smile Doctors Affiliate

    United States
    3 days ago
  •  ...Cambia Health is seeking an Appeals Clinician I to evaluate and finalize clinical appeals across...  ...as needed. Role requires a current RN license and 3+ years of direct clinical care...  ...or insurance settings. Flexible remote work options are available with payscales... 
    Remote work
    Flexible hours

    Cambia Health

    Bluffdale, UT
    3 days ago
  •  ...Cambia Health Solutions is seeking an Appeals Clinician I to work remotely from Oregon, Washington, Idaho or Utah. You will use clinical expertise...  ...with a focus on patient-centered care.The role requires an RN with a Bachelor's degree and at least 3 years of relevant clinical... 
    Remote work

    Cambia Health Solutions

    Idaho Falls, ID
    3 days ago
  •  ...Anthony Patel Orthodontics is seeking an experienced Orthodontic Clinician II to join our growing travel team serving Little Elm, Frisco,...  ...managing patient flow, assisting with lab work, and triaging remote monitoring. We offer competitive salary and comprehensive benefits... 
    Remote work

    Scott Law Ortho Corp PC

    Little Elm, TX
    2 days ago
  •  ...Cambia Health is seeking an Appeals Clinician I to support clinical decision-making on member and provider...  ...with physician advisers while working remotely in Oregon, Washington, Idaho or Utah. Ideal candidates hold an RN license and have 3+ years in clinical settings... 
    Remote work

    Cambia Health

    Renton, WA
    3 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Prior Authorization Clinician II (RN/LVN). Be the first to apply!