Average salary: $66,759 /yearly
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- Infusion Solutions of Delaware seeks a detail-oriented Medical Prior Authorization & Insurance Specialist to join our outpatient practice. The role focuses on coordinating authorizations, verifying coverage, performing benefit investigations, and assisting patients with...Suggested
$89.54k - $136.47k
...registered nurse will be responsible for utilization review services within the scope of licensure. Conducts primary function of prior authorization for inpatient and outpatient reviews both initial and concurrent continued stay review. Reviews for appropriate treatment...SuggestedFull timeTemporary workRemote workShift work$54.1k - $116.77k
...schedules will include holidays and evening hours ~ Associate Degree in Nursing Nice to Have Utilization Management or Prior Authorization experience Managed care background Familiarity with MedCompass Ambulatory surgery experience BSN preferred Why...SuggestedHourly payFull timeTemporary workWork at officeLocal areaRemote workWork from homeMonday to FridayAfternoon shiftWeekday work$174.07k - $374.92k
...primarily on overseeing utilization review / quality assurance and be responsible for predetermination reviews. This includes Prior Authorization / Pre Certification / Concurrent Reviews / Peer to Peer Calls / First Level Appeals / Special Projects and Committee...SuggestedHourly payFull timeTemporary workLocal areaRemote workWork from home$300k
...the country, physicians in every specialty are dealing with the same problems: long hours, nights and call, packed schedules, prior authorizations, overflowing inboxes and less control over how they practice. Burnout has become a nationwide problem, and too many...SuggestedPart timeFor contractorsWork from homeMonday to FridayShift workAfternoon shiftSkilled Wound Care
Wilmington, DE4 days ago$16.76 - $27.53 per hour
...by law. The Utilization Management Representative I (US) will be responsible for coordinating cases for precertification and prior authorization review. How you will make an impact: Manage incoming calls or incoming post services claims work. Determine contract and benefit...SuggestedFull timeContract workTemporary workWork experience placementWork at officeLocal area1 day per weekElevance Health
Wilmington, DE2 days ago- Infusion Solutions of Delaware (ISD) is seeking a detail-oriented and patient-focused Medical Prior Authorization & Insurance Specialist to join our team. This position is responsible for coordinating insurance authorizations, verifying patient insurance coverage and benefits...SuggestedWork at officeWeekend work
- ...pharmacy directory updates with EHR Coordinator · Contact pharmaceutical representatives for sample medications · Obtain prior authorizations for medications and durable medical equipment · Handle new, renewal, and/or refill prescriptions for providers via EMR...SuggestedFull timeWork at office
Brandywine Urology Consultants
New Castle, DE29 days ago $350k - $400k
...Way It Should Be — Full Autonomy, Zero Burnout If you got into internal medicine to actually manage your patients — not fight prior authorizations and hospital bureaucracy — this is the practice you've been looking for. We're a physician-owned and physician-led group, 15...SuggestedFull timeFlexible hoursAfternoon shiftMedrina
Wilmington, DE4 days ago$174.07k - $374.92k
...policy implementation; you will support the ensuring timely and consistent responses to members and providers; you will focus on prior authorization cases and consultation cases. The Medical Director will provide clinical, coding, and reimbursement expertise as well as...SuggestedHourly payFull timeTemporary workLocal areaRemote workWork from homeWeekend work$250k
...care for patients. Instead, too many days are spent running through 15-minute visits, clearing an overflowing inbox, fighting prior authorizations and finishing charts long after the last patient leaves. Across the country, primary care physicians are carrying heavier...SuggestedFull timePart timeFor contractorsAfternoon shiftWeekday work$26.01 - $68.55 per hour
...approx 4-5 months of training Monday - Friday 7:30am-6pm EST with occasional holiday rotation. Preferred Qualifications Prior Authorization or Utilization Management experience Managed care experience Experience using MedCompass Ambulatory surgery...SuggestedHourly payFull timeTemporary workWork at officeMonday to FridayShift workWeekend workAfternoon shift- ...lists in compliance with health-plan, PBM, and regulatory standards. Provide clinical support for utilization management, prior-authorization criteria, and step-therapy guidelines. What you'll bring: Education: PharmD or Bachelor of Pharmacy. Licensure: Active...SuggestedRemote work
- ...outpatient providers and patients and families Call patients and families to report lab results and provide check-ins Facilitate prior authorizations and prescription management Facilitate with flow of clinic Interface with hospice, coordinate admissions, provide ongoing...SuggestedPart time
Nemours in
Wilmington, DE4 days ago - ...information or obtain clinical information for approval of medical authorizations. Uses Aetna Systems such as MedCompass, QNXT, ProFAX and... ...Qualifications: Call center experience is preferred, 1-2 years Prior authorization experience, 1-2 years Education: Associates degree...SuggestedHourly payFull timeTemporary workWork at office
CVS Corporation
Wilmington, DE1 day ago - ...does not accept unsolicited resumes from agencies not under contract. Any resume submitted without a signed agreement and prior written authorization from our Talent Acquisition team will be deemed the property of Allan Myers. We reserve the right to engage with such...Contract workWork experience placementNight shift
Allan Myers
Millsboro, DE4 days ago $250k
...nursing facilities across the area. Maybe you’re a Bariatric Surgeon ready to step away from back-to-back laparoscopic cases, prior-authorization battles and productivity targets at large health systems. Maybe you want clinical autonomy outside the high-pressure hospital...Full timePart timeFor contractorsMonday to FridayAfternoon shiftWeekday workSkilled Wound Care
Wilmington, DE21 hours ago- ...working independently to support physicians and clinicians in a busy cardiology practice. This role includes triaging calls, coordinating testing, processing prior authorizations, and maintaining EMR documentation in a fast-paced ambulatory setting. #J-18808-Ljbffr...
Christiana Care Health System
Wilmington, DE2 days ago - ...administering local anesthetic, and applying allergy test patches, always prioritizing patient safety and well-being. Complete prior authorizations and medication requests efficiently to support timely treatment. Schedule follow-up appointments with care and diligence,...Temporary workLocal areaWeekend work
$90k - $115k
...Qualifications ~ BS Pharmacy or PharmD is required ~5+ years’ experience in the Pharmacy industry working directly with prior authorizations, retail pharmacy, or Specialty pharmacy. ~ Comprehensive knowledge of both pharmacy and medical benefit utilization management...Full timeTemporary workWork at officeLocal areaRemote workFlexible hoursNorstella
Dover, DE21 hours ago- ...arrive with a friendly demeanorSchedule, cancel and reschedule patient appointmentsPrint out electronic orders for patientsSubmit prior authorization requestsScan and upload documents to the patient's electronic medical recordAbility to competently handle patient calls...Full timeWork at officeLocal area
- ...administering local anesthetic, and applying allergy test patches, always prioritizing patient safety and well-being.Complete prior authorizations and medication requests efficiently to support timely treatment.Schedule follow-up appointments with care and diligence,...Temporary workLocal area
$79.87k - $98k
...Medicare Part D regulations and demonstrated accountabilities in areas such as coverage determinations, appeals and grievances, prior authorizations, formulary management, transition monitoring, etc. is preferred ~ Experience in government program compliance oversight...Full timeWork experience placementRemote workFlexible hours$300k
...Significant Administrative Support: You focus on patient care, and we'll handle scheduling, insurance verification, billing, prior authorizations, pharmacy coordination, etc. Patient Acquisition: Unlike with a private practice, we'll work to fill your schedule, so...Remote jobWeekly payFull timePart timeFor contractorsPrivate practiceImmediate startWork from home$101.34k - $126.67k
...Virginia, Washington, Washington DC, Wisconsin. Overview Navitus Health Solutions is seeking a Pharmacist I, Clinical Prior Authorization to join our team! The Pharmacist I, Clinical Prior Authorization will be responsible for: performing Prior Authorizations...Full timeWork experience placementRemote workFlexible hours$44.6k - $59.75k
...succeed, the Company succeeds. About the Role This position is responsible for receiving verbal and written requests for prior authorization from pharmacists, physicians and/or members. They are accountable for supporting and assisting in the coordination of Pharmacy...Full timeLive inWork at officeLocal area$60.53k - $129.63k
...providers and interdisciplinary care teams to support treatment planning Apply clinical judgment to utilization management and prior authorization decisions Identify opportunities to improve quality, outcomes, and member experience Serve as a trusted clinical...Hourly payFull timeTemporary workWork at officeLocal areaRemote workWork from homeMonday to FridayAfternoon shift- ...interventions, and oversee specialty medication therapies. Additional duties encompass supporting patient access to medications through prior authorizations and financial assistance programs, precepting pharmacy students and residents, contributing to research and quality...Monday to Friday
Soliant Health
Dover, DE3 days ago $15 - $17 per hour
...Healthcare Coordinator plays a critical role in managing referrals, authorizations, and ensuring patients can follow through on their care plans.... ...patient referrals and coordinate with providers Manage prior authorizations for services Communicate with patients by phone...Casual workLocal areaMonday to Friday- ...insurance Collecting co-pays and co-insurance payments Updating demographics and insurance information in the EMR Obtaining prior authorizations and referrals when necessary Obtaining appropriate Release of Information signatures as needed Answering the phone while...Full time
