Average salary: $95,135 /yearly
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$87k
...Job Description PURPOSE The Registered Nurse (RN) Referral Navigator plays a critical... ..., internal, and outbound referrals and authorizations, verifies insurance, and supports care transitions... ...pre-consultation requirements needed prior to appointment scheduling. Improves...SuggestedWork at officeDell Medical School
Austin, TXa month ago- ...We are seeking a compassionate and experienced Registered Nurse (RN) with a strong background in diabetes care and outpatient... ...and monitor patient safety · Assist with medication prior authorizations and insurance appeals · Coordinate with pharmacies regarding...SuggestedFull timeRemote workMonday to FridayWeekend workAfternoon shift
IMS People
New York, NY6 days ago - ...Compact State ~ Associate’s degree (Bachelor’s preferred) or diploma from an accredited nursing program ~2+ years of Utilization Review/Management (UR/UM) and/or Prior Authorization experience ~2+ years of medical necessity review experience ~1+ year of InterQual...SuggestedRemote jobContract workPart timeWork at officeMonday to FridayWeekend work
Astyra Corporation
Indianapolis, IN4 days ago $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...SuggestedFor contractorsWork at officeImmediate start- ...preparing patients for the encounter like rooming, obtaining vitals, weight and health histories, verifying insurance, obtaining prior authorizations, working with an EHR, chart preparation, performing EKG · Monitoring lab values and other diagnostic test results as well...SuggestedWork experience placementRemote work
Cardiac Rhythm Specialists, PA
Houston, TX22 days ago - ...UnitedHealth Group is looking for a Secondary Review Nurse in Indiana. This role requires a current RN license and involves evaluating... ...include collaborating with care managers and processing prior authorization requests. Ideal candidates must have at least 3 years of...SuggestedRemote workWork from home
Crains Cleveland
Indianapolis, IN1 day ago - ...Utilization Management, Registered Nurse (RN) Remote - USA At Clover Health, we are committed to providing high-quality, affordable... .... Responsibilities Perform medical necessity reviews for prior authorization and concurrent review across acute inpatient, post-acute (SNF...SuggestedWork at officeRemote workFlexible hours
Clover Health
New York, NY3 days ago - ...management in a remote environment. Ideal candidates should hold an Associate's Degree in Nursing, possess strong decision-making and problem-solving skills, and have prior authorization experience in a managed care setting. Responsibilities include authorization requests...SuggestedRemote work
Santa Barbara Cottage Hospital
New York, NY3 days ago - ...dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our growing healthcare team. In this role,... ...using evidence-based criteria (e.g., MCG). Evaluate and process prior authorization (PA) requests in a timely, compliant manner. Collaborate with...SuggestedRemote work
Appworkshub
New York, NY3 days ago - ..., and chief complaints accurately. Assist physicians and nurses during medical procedures. Administer injections, medications... ...records (EHR) for patients. Complete insurance forms, prior authorizations, and medical billing tasks as required. Ensure patient...SuggestedWork at officeRemote work
ATLANTIC COVE MEDICAL GROUP LLC
Sarasota, FL14 days ago - ...Assistant to join our team! As a Medical Assistant, you will be preparing for each patient visit by preparing charts, verifying prior authorizations and pulling notes before their arrival, providing routine support alongside medical staff, and assisting with keeping track...SuggestedWork at office
BOLAND NEUROLOGY LLC
Pensacola, FL4 days ago - ...immunizations, and collecting lab specimens Providing phone and front-desk support Assisting with prescription refills and prior authorizations Performing phlebotomy, x-rays (if certified), and clinic lab tests What They Offer: Comprehensive benefits...Suggested
K.A. Recruiting
Minneapolis, MN3 days ago $36 - $40 per hour
...career. If you are an Appeals and Denials Nurse looking for a new opportunity to sharpen... ...career goals and needs! Applicants must be authorized to work in the US. We are unable to... ...0.00 1 month ago Clinical Review Nurse - Prior Authorization Clinical Review Nurse - Prior...SuggestedPermanent employmentFull timeRemote workWork visaNorwood
New York, NY3 days ago$52 - $57.88 per hour
...A nonprofit health plan is seeking a Prior Authorizations Nurse (RN) for a temporary remote position in California. The role involves ensuring prior authorization requests are compliant with standards and requires a Bachelor’s degree in Nursing along with a valid RN license...SuggestedTemporary workRemote workCentral California Alliance for Health
New York, NY3 days ago- ...Healthiest Employer", may be the place for you! The ICWP Review Nurse, as a member of a professional multi-disciplinary work team,... ...Medicaid Waiver programs Experience with utilization management, medical review, or prior authorization *If interested, please applySuggestedContract workRemote work
Alliant Health Solutions
Atlanta, GA1 day ago - ...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 States3 days ago $40 per hour
...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...Hourly payPart timeWork at officeRemote workShift workCatholic Charities
Lutherville Timonium, MD21 hours ago$72.8k - $130k
...Requisition number: 2346557 Job category: Nursing Optum Insight is improving the flow... ...that includes a review of current and prior patient conditions, documents, and... ...of process flow of UM, including prior authorization, concurrent authorization, and/or clinical...Minimum wageFull timeWork experience placementCasual workLive inWork at officeLocal areaRemote workUnitedHealth Group
Boston, MA21 hours ago$28.94 - $51.83 per hour
...to start Caring. Connecting. Growing together. The UM Nurse, Non SRT plays a critical role in evaluating clinical requests... ...regulations. In addition, must assist with oversight of prior authorization, medical necessity determinations, concurrent review, retrospective...Hourly payMinimum wageFull timeContract workWork experience placementWork at officeLocal areaRemote workUnitedHealth Group
Indianapolis, IN4 days ago$65k - $75k
...skilled and motivated Precertification & Pre-Service Appeals Nurse to join our team. In this role, you will be the clinical... ...clinical documentation against medical necessity criteria, secure prior authorizations, and manage the pre-service appeals process. Your clinical...Work at officeLocal areaRemote workWork visaFlexible hours1 day per weekNJ CURE
Princeton, NJ1 day ago$40 per hour
...Job Title: Utilization Management Nurse - Behavioral Health Focus (Remote) Time... ...to review provider-submitted service authorization requests and evaluate medical necessity,... ...appropriate and timely care by performing prior authorizations and concurrent reviews....Hourly payPermanent employmentTemporary workWork at officeRemote workMorgan Stephens
United States2 days ago- ...Intake Registered Nurse (RN) Opportunity The Pavilion Behavioral Health System includes a 110 bed inpatient hospital, a residential... ...Office regarding patient financial data and verification and prior authorization of insurance benefits as needed, as well as with the UR...Work at officeLocal area
IntelyCare
Champaign, IL3 days ago $95k - $120k
...certification OR ability to get certification prior to starting** Position: DRG Auditor... ...background in either facility-based nursing, clinical documentation, and/or inpatient... ...Center RN Clinical Review Nurse - Prior Authorization RN - Clinical Documentation Nurse (Local...Hourly payFull timeLocal areaImmediate startRemote workMonday to FridayInsight Global
New York, NY3 days ago- ...schedulingappointments, maintaining the reception area, gathering demographic information, verifyinginsurance eligibility, obtaining prior authorizations, collecting copayments, andcommunicating via the phone and patient portal. What you’ll learn Master multitasking as it...Work at office
Jefferson Community College
Temecula, CA21 hours ago - ...even if your experience doesn't match every requirement. About the role The Pre-Certification Nurse is responsible for all aspects of the prior authorization process for members of Quantum Health's employer groups. The nurse is responsible for acquiring all...Permanent employmentCasual workWork at officeWork from home
Quantum Health
Dublin, OH3 days ago $34.98 - $42.85 per hour
...diversity and innovation. Job Summary The UM Nurse I - RN performs clinical review of authorization requests to determine medical necessity based on... ...Responsibilities • Conduct clinical review of prior authorization requests using approved criteria (e.g....Hourly payWork at officeRemote workClever Care Health Plan
Huntington Beach, CA4 days ago$28.94 - $51.63 per hour
...Requisition number: 2359998 Job category: Nursing At UnitedHealthcare, we're simplifying the health care experience, creating... ...setting ~ Knowledge of utilization review process and prior authorization process in a managed health care industry ~ Knowledge of ICD...Hourly payMinimum wageFull timeWork experience placementLocal areaRemote workMonday to FridayUnitedHealth Group
United States21 hours ago$19.37 - $28.09 per hour
...the institution and external off-site coverage (I.e. Skilled Nursing Facility, PreAdmission Testing). Performs tasks such as Test... ...Medical Necessity requirements. Acquires consent forms, prior authorization data and/ or ABN's when applicable. Demonstrates ability...Hourly paySeasonal workWork at officeRelocation packageFlexible hoursShift workUnited Health Services
Binghamton, NY21 hours ago- ...Phlebotomist 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...Work at officeRemote workMonday to Friday
POD Health
Bronx, NY2 days 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, CA4 days ago
