Average salary: $95,135 /yearly

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  • Medical social worker

     ...due to member's health needs; including but not limited to: Prior Authorizations, Coordination with PCP and skilled providers, Condition management...  ...at their homes, in Assisted Living Facilities and Skilled Nursing Facilities. **Must be fluent in English & Spanish and be... 
    Suggested
    Temporary work
    Work experience placement
    Remote work
    Monday to Friday

    Randstad

    United States
    1 day ago

  • Registered Nurse (RN) Referral Navigator

    $87k

    Registered Nurse (RN) Referral Navigator Hiring Department: Dell Medical School Position...  ..., internal, and outbound referrals and authorizations, verifies insurance, and supports care...  ...and pre-consultation requirements needed prior to appointment scheduling. Improves... 
    Suggested
    For contractors
    Work at office
    Immediate start

    Phase2 Technology

    Austin, TX
    4 days ago

  • Registered Nurse (RN) Referral Navigator

    $87k

     ...PURPOSE The Registered Nurse (RN) Referral Navigator plays a critical role in supporting...  ..., internal, and outbound referrals and authorizations, verifies insurance, and supports care...  ...and pre-consultation requirements needed prior to appointment scheduling. Improves... 
    Suggested
    Work at office

    Dell Medical School

    Austin, TX
    1 day ago

  • Medical Assistant/Phlebotomist

     ...opportunity to work with a collaborative team of medical providers, nurses, counselors and medical registration staff. The successful...  ...records in the electronic health record (EHR) Assists with prior authorizations. Answers phones and provides administrative support to... 
    Suggested
    Work experience placement
    Work at office
    Monday to Friday

    CompDrug

    Columbus, OH
    4 days ago

  • Certified Phlebotomist $250 Sign-on Bonus (Bilingual: Chinese)

     ...Assistant will play a vital role in providing support to a team of nurses and nurse practitioners in delivering exceptional patient...  .... Verify patient insurance coverage and obtain prior authorizations as required. Schedule virtual patient appointments with Nurse... 
    Suggested
    Work at office
    Remote work
    Relocation package
    Monday to Friday
    2 days per week
    3 days per week

    POD Health

    New York, NY
    9 hours ago

  • Medical Assistant or Licensed Practical Nurse - Float

    $20.86 - $32.42 per hour

     ...for patients' care, comfort, and safety. Licensed Practical Nurse The Licensed Practical Nurse (LPN) works under the...  ...Completes steps to fill prescriptions per protocol and completes prior authorization forms to ensure proper billing and fill of the prescription for... 
    Suggested
    Full time
    Part time
    Shift work

    Sanford Health

    Iron Mountain, MI
    9 hours ago

  • Patient Care Technician II - Primary Family Med

     ...appointment. Other responsibilities may include returning messages, scheduling follow up tests, referrals and prior authorizations. Assists patients, nurses and providers in patient care in the clinic setting. Performs vital signs, and obtains history of chief complaint... 
    Suggested
    Full time
    Work at office
    Immediate start
    Shift work

    CHRISTUS Health

    Santa Fe, NM
    9 hours ago

  • Clinical Medical Assistant

    $49.37k

     ...requires immediate action. Including being detail oriented when receiving/entering refills for medications, receiving/entering Prior Authorization for providers, review of results or correspondence received from other healthcare providers with our eye care providers and... 
    Suggested
    Immediate start
    Afternoon shift

    State University of New York College of Optometry

    New York, NY
    4 days ago

  • Nurse Clinician - RN

     ...are seeking a full time, motivated and talented Registered Nurse Clinician to join our busy, fast paced specialty office at Twin...  ...correspondence and patient reports as needed Obtains prior authorization for medications as required Works closely with Prior Authorization... 
    Suggested
    Full time
    Temporary work
    Work at office
    Remote work
    Monday to Friday
    Flexible hours

    Twin Cities Spine

    Minneapolis, MN
    9 hours ago

  • Clinic Nurse (RN) - Decatur (U) (2703)

    $27.16 - $29.88 per hour

     ...individual will provide efficient and effective nursing support to the practicing physicians and...  ...for treatment. f. Reviews E.H.R. prior to patient appointment to ensure that...  ...calendaring system, securing prior authorizations and medical consents, monitoring lab results... 
    Suggested
    Hourly pay
    Work at office
    Local area
    Immediate start
    Relocation package
    Monday to Friday
    Flexible hours
    Shift work

    Southern Illinois University School of Medicine

    Springfield, IL
    2 days ago

  • Preauthorization Registered Nurse

     ...Responsibilities Clinical Review Conduct comprehensive clinical reviews of prior authorization requests to determine medical necessity and benefit...  ...SkillBridge or military spouse fellowship. Active Registered Nurse (RN) with an enhanced Compact (eNLC) license without... 
    Suggested
    Full time
    Work experience placement
    Internship
    Remote work
    Work from home
    Weekday work

    Humana

    Wisconsin
    5 hours agonew

  • Hybrid Review Nurse, Prior Authorization/Utilization Management

     ...Are you a bedside nurse seeking a change from the hospital setting? If you answered "yes", Alliant Health Solutions, a "2025 Best...  ...you! Alliant is recruiting a Hybrid Review Nurse for its Prior Authorization and Utilization Management (PA/UM) team. The Review Nurse... 
    Suggested
    Contract work
    Remote work

    Alliant Health Group

    United States
    5 days ago

  • Nurse Navigator-Exempt, Cancer Center, Hematology, Days, 24 Hours

    $83.12k - $149.59k

     ...recommended follow up and resources available. 3. Utilizes nursing process to comprehensively assess the patients' physical and...  ...to the theranostic treatment plan. 3. Responsible for Prior Authorization of treatment plan and associated imaging. 4. Orders radiopharmaceutical... 
    Suggested
    Work at office
    Immediate start
    Remote work
    Relocation package
    Monday to Friday
    Shift work
    Day shift

    U Mass Memorial Health

    Worcester, MA
    5 hours agonew

  • Registered Nurse (RN)

     ...Job Title: Registered Nurse (RN) Location: Baton Rouge, LA 70805 Duration: 3 Months+ - (Possible Extension)...  ...update patient medications; manage prescription refills and prior authorizations. Educate patients on chronic conditions (diabetes, cardiovascular... 
    Suggested
    Remote work
    Monday to Friday

    Integrated Resources

    Baton Rouge, LA
    9 hours ago

  • Utilization Management Nurse, Senior

     ...The Utilization Management team manages accurate and timely prior authorization and inpatient stays reviews for our members and correctly applies...  ...review, transplant and NICU/HROB. The Utilization Management Nurse, Consultant will report to the Manager, Utilization and... 
    Suggested
    Full time
    Contract work
    Part time
    Work at office
    Local area
    Remote work
    Work from home
    Home office
    2 days per week

    Blue Shield Of California

    Rancho Cordova, CA
    9 hours ago

  • Health Plan Nurse Coor. UM Adult (Talent Pipeline)

    $84.88k - $123.07k

     ...local customers is valued. Job Summary The Health Plan Nurse Coordinator - Adult Utilization Management (HPNC - Adult UM)...  ...prospective (pre-service) reviews for services requiring prior authorization. Perform timely concurrent reviews for inpatient care in... 
    Contract work
    Local area
    Immediate start
    Remote work
    Flexible hours

    Cencal Health

    Santa Barbara, CA
    1 day ago

  • Clinical Nurse (DOM Gastroenterology) - #Staff

    $64.6k - $113.3k

     ...We are seeking a Clinical Nurse in the department of Gastroenterology who will serve as a patient advocate and is part of a team...  ...ensure appropriate follow-up with patients. Assist with prior authorization requests for testing/treatments and medications as needed.... 
    Full time
    Work at office
    Remote work
    Flexible hours

    Johns Hopkins University

    Baltimore, MD
    2 days ago

  • Intake Psych Registered Nurse RN Full Time Nights

     ...Thank you for considering our Intake Psychiatric Registered Nurse position as we continue our successful opening! More information...  ...Office regarding patient financial data and verification and prior authorization of insurance benefits as needed, as well as with the UR... 
    Full time
    Work at office
    Local area
    Relocation package
    Shift work
    Night shift

    Universal Health Services

    Byron Center, MI
    2 days ago

  • Registered Nurse (WFH/Hybrid)

    $40 per hour

     ...area and New Jersey, our incredible team of pediatricians, nurse practitioners, and clinical support staff practices a unique...  ..., and medication forms Liaison with insurances regarding prior authorizations, patient care, medications reviews, and coordination of care... 
    Full time
    Temporary work
    Seasonal work
    Work at office
    Remote work
    Work from home

    Tribeca Pediatrics

    United States
    4 days ago

  • Sr. Utilization Management Nurse - Field RN

    $72.8k - $130k

     ...needs. As a Sr Utilization Management Nurse in the Boston MA Regional Area, the role...  ...that includes a review of current and prior patient conditions, documents, and evaluations...  ...of process flow of UM, including prior authorization, concurrent authorization, and/or... 
    Minimum wage
    Full time
    Work experience placement
    Casual work
    Live in
    Work at office
    Local area
    Remote work

    Optum

    Boston, MA
    2 days ago

  • Registered Nurse 1

     ...opportunity for a full-time Registered Nurse 1 to work in Miami, FL. The Registered Nurse...  ...obtaining pre-certifications and pre-authorizations for procedures and medications, scheduling...  ...matters such as appeal letters prior authorization. Serve as nursing coverage... 
    Full time
    Temporary work
    Remote work
    Worldwide

    The University of Miami

    United States
    6 days ago

  • Nurse Rev II-Case Mgt

     ...Medical School is seeking a detail-oriented Nurse Reviewer II with experience caring for...  ...- assessing, planning, coordinating, and authorizing care for individuals with complex medical...  ...regulations ~ Experience with prior authorization and/or eligibility determinations... 
    Work experience placement
    Work at office
    Remote work

    University of Massachusetts Medical School

    Westborough, MA
    9 hours ago

  • Utilization Management Policy Initiatives Registered Nurse

     ...The Utilization Management Policy Initiatives Nurse RN II, under the purview the Utilization Management (UM)...  ...decision making resources, using data on clinical polices and authorizations to update our prior authorization rules, defining clinical paradigms for coding... 
    Remote work

    Macpower Digital Assets Edge

    United States
    4 days ago

  • REGISTERED NURSE

     ...laboratory and diagnostic imaging and report results. Obtain prior authorization for services, medications and/or communicate the need for...  ...minor in office surgical procedures as needed. Provide nursing triage as needed including, emergency, isolation, crisis intervention... 
    Work at office

    Care Resource

    Miami, FL
    1 day ago

  • Utilization Management Nurse II, RN

    $88.36k - $100k

     ...and innovation. Job Summary The UM Nurse II - RN performs advanced clinical review of complex authorization requests and serves as a clinical escalation...  ...Responsibilities • Conduct clinical review of prior authorization requests using approved criteria... 
    Work at office
    Remote work

    Clever Care Health Plan

    Huntington Beach, CA
    3 days ago

  • Registered Nurse - Part Time - SVV

     ...Catholic Charities of Baltimore is seeking a Part Time Registered Nurse to provide nursing care as needed within the Family Services...  ...coordination, and regulatory compliance. Manages prior authorizations, collaborating with providers, pharmacies, and insurance companies... 
    Part time
    Work at office
    Remote work
    Shift work

    Catholic Charities

    Lutherville Timonium, MD
    1 day ago

  • Registered Nurse, Institutional - ACT Team / Community (RN) (Aiken)

    $70.46k - $89.8k

     ...accessible care to our community. We are seeking a Registered Nurse / ACT Team / Community (Aiken) who is motivated to help...  ...and Risk Management Plan. Ensure timely completion of prior authorizations. Pursue professional, development through collegial consultation... 
    Full time
    Temporary work
    Work at office
    Remote work
    Monday to Friday
    Flexible hours
    Afternoon shift

    State of South Carolina

    Cayce, SC
    4 days ago

  • RN / Registered Nurse - Neurology Clinic at Meridian Pavilion

    $45.59 per hour

     ...Pavilion has an outstanding opportunity for a Registered Nurse . WORK SCHEDULE Full time / 40 hours per week...  ...Obtain medical records and test results for providers Manage prior authorizations and outgoing referrals Provide nursing advice in person,... 
    Hourly pay
    Full time
    Temporary work
    Work at office
    Remote work
    Monday to Friday
    Shift work
    Night shift
    Weekend work
    Day shift

    University of Washington

    United States
    3 days ago

  • Clinic Registered Nurse- Nashua .8 FTE

     ...PRIMARY FUNCTIONS 1. In keeping with Chapter 6 of the Iowa Nursing Practice Act for Registered Nurses, the ANA Scope and...  ...procedures as directed, contacts insurance company to obtain prior authorization. Documents telephone encounters, capturing pertinent data... 
    Contract work
    Work at office
    Shift work
    Day shift

    Waverly Health Center

    Waverly, IA
    1 day ago

  • Registered Nurse (outpatient clinic setting)

     ...Seeking a full time Registered Nurse to join a great community health / family...  ...information necessary for the provider to authorize the refill • Administers immunizations...  ...the scope of nursing practice, including prior authorization forms • Provides health... 
    Full time

    K.A. Recruiting

    Beverly, MA
    1 day ago