Average salary: $95,135 /yearly
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- ...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...SuggestedTemporary workWork experience placementRemote workMonday to Friday
Randstad
United States4 days ago $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...SuggestedWork at officeDell Medical School
Austin, TX5 hours ago- ...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...SuggestedWork at officeRemote workRelocation packageMonday to Friday2 days per week3 days per week
POD Health
New York, NY3 days ago - ...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...SuggestedFull timeWork at officeImmediate startShift work
CHRISTUS Health
Santa Fe, NM3 days ago $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...SuggestedFull timePart timeShift workSanford Health
Iron Mountain, MI3 days ago$28.37 - $39.19 per hour
...Associate's degree (bachelor's preferred) or Practical/Professional nursing diploma from an accredited nursing school, college, or... ...of 2+ years of Utilization Review/Management (UR/UM) and/or Prior Authorization experience. A minimum of 2+ years of medical necessity...SuggestedContract workReliefWork at officeLocal areaRemote workMonday to FridayFlexible hoursWeekend workAcentra Health
McLean, VA5 hours ago$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....SuggestedFull timeWork at officeRemote workFlexible hoursJohns Hopkins University
Baltimore, MD5 hours ago$81.22k - $121.83k
...process Appropriate prioritization of authorization requests Achievement of expected... ...productivity goals Review of all assigned prior authorization requests including but not... ...Education Required (minimum): BS Nursing; LICSW, LMHC, or other behavioral health...SuggestedContract workWork at officeWork from homePoint32Health
Canton, MA4 days ago$17.71 - $24.94 per hour
...schedules, memos, etc., as directed. May be required to accept co-payments. Handles, screens and/or takes messages related to prior authorizations, provider questions, prescription refills, and test results. Acts as "Super User" for scheduling, registration and billing...SuggestedHourly payDaily paidWork at officeRemote workShift workMassachusetts General Hospital
Danvers, MA3 days ago$28.37 - $33 per hour
...to the review processes, functions as the initial resource to nurse reviewers regarding all review process questions and/or... ...Preferred Qualifications Minimum of one year UR and/or Prior Authorization or related experience. Requires excellent written and verbal...SuggestedContract workWork at officeLocal areaRemote workFlexible hoursShift workWeekend workAcentra Health
McLean, VA2 days ago- ...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...SuggestedRemote workMonday to Friday
Integrated Resources
Baton Rouge, LA3 days ago - ...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...SuggestedFull timeContract workPart timeWork at officeLocal areaRemote workWork from homeHome office2 days per week
Blue Shield Of California
Rancho Cordova, CA3 days ago - ...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...SuggestedFull timeTemporary workRemote workWorldwide
The University of Miami
United States4 days ago - ...Registered Nurse Clinician Twin Cities Spine Center is a nationally recognized Spine Surgeon group who has served the Twin Cities... ...correspondence and patient reports as needed Obtains prior authorization for medications as required Works closely with Prior Authorization...SuggestedFull timeTemporary workWork at officeRemote workMonday to FridayFlexible hours
Twin Cities Spine Center
Minneapolis, MN1 day ago $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...SuggestedWork at officeImmediate startRemote workRelocation packageMonday to FridayShift workDay shiftU Mass Memorial Health
United States4 days ago$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 timeTemporary workSeasonal workWork at officeRemote workWork from homeTribeca Pediatrics
United States2 days ago$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 wageFull timeWork experience placementCasual workLive inWork at officeLocal areaRemote workOptum
Boston, MA5 hours ago- ...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 timeWork at officeLocal areaRelocation packageShift workNight shift
Universal Health Services
Byron Center, MI13 hours ago $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...Hourly payWork at officeLocal areaImmediate startRelocation packageMonday to FridayFlexible hoursShift workSouthern Illinois University School of Medicine
Springfield, IL5 hours ago$28.37 - $32 per hour
...to the review processes, functions as the initial resource to nurse reviewers regarding all review process questions and/or... ...related field Some knowledge of Case Management, UR and/or Prior Authorization or related experience is preferred Experience in call center...Contract workLocal areaRemote workFlexible hoursShift workAcentra Health
McLean, VA5 hours ago- ...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...Contract workRemote work
Alliant Health Group
United States3 days ago $80k
...Nurse Rev II-Case Mgt Minimum Salary US-MA-Westborough Job Location... ...Program. This position is responsible for the authorization, coordination and facilitation of long... ...state regulations ~ Experience with prior authorization and/or eligibility...Full timeWork experience placementWork at officeRemote workShift workUMass Med School
Westborough, MA3 days ago- ...difference, consider applying for the position of Utilization Review Nurse. As a Utilization Review Nurse, you will leverage a... ...injuries. Key Responsibilities: Conduct prior authorization, concurrent, and retrospective reviews. Utilize clinical documentation...Remote work
Public Consulting Group
Columbus, OH1 day ago - ...Acute Hospital Experience by Specialty Pediatrics* ICU MS Case Management/Utilization Review Pre-Cert Review* Prior Authorizations* Retrospective Review* Admission Criteria Care coordination Concurrent Review Continued Stay Reviews...Remote work
B2B Staffing Services
Torrance, CA3 days ago $67k - $68k
...Immediate need for a talented RN (Registered Nurse). This is a Fulltime opportunity with long-term potential and is located... ...and make on-line payment determinations for claims and prior authorizations that require medical determination. Review exception requests...Full timeWork at officeLocal areaImmediate startRemote workPyramid Consulting
United States1 day ago- ...Work At Home, LA Contract 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...Contract workWork from home
US Tech Solutions
Baton Rouge, LA1 day ago - ...determinations following physician review. The ideal candidate will have prior authorization (outpatient review) experience in a managed care setting... .... Education ~ Associate's Degree Nursing required or Bachelor's Degree Nursing preferred...Remote work
Mass General Brigham Health Plan
Somerville, MA1 day ago $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 workLocal areaImmediate startRemote workFlexible hoursCencal Health
Santa Barbara, CA4 days ago$26.41 - $51.49 per hour
...Job Description Job Summary Are you seeking a unique nursing position that gives you a great work/life balance and lets... ...and reviews and revises plan of care as needed Submits for Prior Authorization for personal care services Complies with all Department...Hourly payWork experience placementWork at officeRemote workMolina Healthcare
Milwaukee, WI2 days ago$40.65k - $50.82k
...on Electronic Medical Record system. The job duties include but are not limited to medication proposals for IMG practices, prior authorizations, healthcare concierge webforms and follow up calls, completion of standing orders for care gap closure, lab and test result...Full timeWork at officeWork from homeShift work
