Average salary: $42,500 /yearly
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- ...Utilization Review Specialist in Roseburg, Oregon. This full-time role involves supporting the medical management team with prior authorizations. Responsibilities include managing documentation, communicating with providers, and ensuring compliance with regulations. Candidates...SuggestedFull time
Umpqua Health
Roseburg, OR3 days ago $22 - $32 per hour
...patients by navigating insurance portals and obtaining necessary authorizations for treatment. Key responsibilities include reviewing medical... ...have a high school degree and a minimum of three years of prior authorization experience. The position offers a salary range of...SuggestedHourly payFull timeUS Oncology
Eugene, OR3 days ago- ...A healthcare facility is seeking a Prior Authorization Specialist in Eugene, Oregon. This role involves managing insurance approvals for medical and ancillary services while ensuring accurate submissions of clinical documentation. The ideal candidate will have 2 to 5 years...Suggested
Slocum Center
Eugene, OR7 days ago $23 - $25 per hour
...Boulder Care**, located in Portland, Oregon, is looking for a Prior Authorization Specialist. In this role, you will ensure patients receive timely medication approvals by obtaining insurance prior authorizations and troubleshooting submissions with healthcare providers...SuggestedHourly payRemote workBoulder Care
Portland, OR5 days ago$2,412 per week
.../Rehab/Skilled Nursing*, NCQA (National Committee for Quality Assurance)*, Needs Assessment/ Order DME, OSHA, Plan of Care, Prior Authorizations, The Joint Commission/ Core Measure/National Safety Goals Unit Details Staffing & Scheduling Scheduling Type : block Patient...SuggestedDaily paid16 hoursPermanent employmentFull timeContract workTemporary workLocal areaShift workNight shiftWeekend workTravelNurseSource
Portland, OR5 days ago$2,412 per week
.../Rehab/Skilled Nursing*, NCQA (National Committee for Quality Assurance)*, Needs Assessment/ Order DME, OSHA, Plan of Care, Prior Authorizations, The Joint Commission/ Core Measure/National Safety Goals Unit Details Staffing & Scheduling Scheduling Type : block Patient...SuggestedDaily paid16 hoursPermanent employmentFull timeContract workTemporary workLocal areaShift workNight shiftWeekend workMindlance Health
Portland, OR5 days ago- ...Health Care is seeking an Insurance Verification Specialist who will verify insurance for incoming referrals and coordinate prior authorization requirements. The ideal candidate should possess extensive knowledge of Medicare, Medicaid, and Commercial Products, alongside...SuggestedWork at office
- ...Perform financial clearance of patient accounts by verifying insurance eligibility and benefits. Ensure all notifications and authorizations are completed within the required timeframe. Completes appropriate payor forms related to notification and authorization....SuggestedWork at officeImmediate start
Baylor Scott & White Health
Salem, OR5 days ago - Insurance Verification Specialist Responsibilities & Duties: Verifying insurance for incoming referrals. Communicate prior authorization and referral requirements and request when necessary. Work with billing team on post-authorizations. Request single case agreements...SuggestedWork at office
$215k - $235k
...to therapy. As a trusted resource and advocate, the PAL provides education, guidance, and support across insurance coverage, prior authorization, medical exceptions, appeals, affordability programs, and adherence to ensure patients can begin and continue therapy with confidence...SuggestedWork at officePriovant Therapeutics
Portland, OR2 days ago$22 - $32 per hour
...by navigating insurance portals and obtaining all appropriate authorizations. With a focus on authorizations for infusion drugs, radiation... ...rate is dependent on many factors, including but not limited to: prior work experience, education, job/position responsibilities,...SuggestedFull timeWork experience placementWork at officeShift workUS Oncology Network-wide Career Opportunities
Eugene, OR13 days ago- ~ Submits, tracks, and manages prior authorization requests for medical and ancillary procedures, within strict timeframes. ~ Researches and resolves authorization and referral claim denials, while coordinating with physicians, providers, and insurance payers to file...SuggestedWork at officeRemote work
Slocum Center
Eugene, OR4 days ago - ...A confidential managed care organization is seeking a Remote Prior Authorization Pharmacist to evaluate prescription requests and improve patient access to therapies. This fully remote position allows pharmacists to build expertise in managed care. Responsibilities include...SuggestedRemote workFlexible hours
Pharmacy Careers
Portland, OR3 days ago $301.4k - $335k
...first model that lets you reclaim your time and passion for medicine. What does this look like for your practice? ~ No prior authorizations. Seamless collaboration with specialty care ~ No call. You can unplug while team physicians cover your patients and your...SuggestedPart timeImmediate startRelocation packageNorthwest Permanente
Portland, OR3 days ago$2,734 - $2,889 per week
...contribute to population-based disease management and policy development. You will conduct drug utilization reviews, support prior authorizations and care coordination, and craft patient-specific medication action plans while communicating recommendations clearly to...SuggestedContract workTraineeshipRemote workWork from homeFlexible hoursShift workWeekday workB2B Staffing Services
Portland, OR6 days ago$49.34 - $76.59 per hour
A leading healthcare organization is seeking a Utilization Review RN for a fully remote role in Oregon. Candidates must hold an Oregon Registered Nurse License and have at least 5 years of clinical nursing experience, particularly in collaboration with physicians. This...Remote workProvidence Health & Service
Portland, OR3 days ago- ...patients. Conduct medication reviews to identify gaps in therapy, adherence concerns, or potential drug interactions. Support prior authorization and appeals processes when needed. Educate patients and caregivers on medication regimens and disease state management....Remote work
Pharmacy Careers
Portland, OR3 days ago $121.6k - $164.5k
...value in efficacy, safety and affordability. This may include providing coverage recommendations for medications subject to prior authorization, appeals, retrospective claim reviews, and audits based on applicable medication coverage policies, member benefit contracts,...Immediate startRemote workWork from homeFlexible hoursCambia Health Solutions
Portland, OR7 days ago$85.99k - $105.34k
...Utilization Review Nurse for a full-time remote position. The role involves evaluating clinical service requests, conducting prior authorization reviews, and collaborating with interdisciplinary teams. Applicants should have an active RN license and at least five years...Full timeRemote workUmpqua Health
Roseburg, OR3 days ago- ...Remote Prior Authorization Pharmacist – Work From Home in Managed Care A confidential managed care organization is seeking a motivated Remote Prior Authorization Pharmacist to evaluate prescription requests, ensure medical necessity, and improve patient access to safe...Remote workWork from homeFlexible hours
Pharmacy Careers
Beaverton, OR3 days ago $23.16 - $31.26 per hour
...insurance, or other payment types. Verifies coverage and ensures all insurance requirements are met, as well as obtaining all prior authorization and/or referrals as appropriate prior to patient arrival. Responds to customer’s inquiries. Assists with departmental...Daily paidWork at officeLocal areaPeaceHealth
Eugene, OR7 days ago$41.6k - $47k
...Utilization Review Specialist provides support to the Umpqua Health Alliance (UHA) for the intake, processing and finalization of all prior authorizations received by Medical Management in compliance with regulatory requirements. Essential Job Responsibilities Provide support...Full timeWork at officeLocal areaImmediate startRemote workMonday to FridayFlexible hoursShift workUmpqua Health
Roseburg, OR2 days ago- ...personal computer and various software programs applicable to the position* Demonstrates basic understanding of insurance and prior authorization requirements.* Demonstrate knowledge and skills needed to provide appropriate levels of service to Radiology customers in...Full timeWork at officeShift workDay shift
Bay Area Hospital
Coos Bay, OR2 days ago - ...from an accredited program. OR an equivalent combination of training and experience. Desired Attributes Experience submitting prior authorization requests for Medicaid billing. Ability to apply administrative rules for audit and quality assurance. Experience...
State of Oregon
Pendleton, OR2 days ago $22.51 - $27.57 per hour
...0 days. Enters information in the system for reverse billing. Completes third party billing form and contacts Provider if prior authorization is required. Performs clinical responsibilities in alignment with The Joint Commission (TJC), Health Resources and Services...Part timeInternshipWork at officeYakima Valley Farm Workers Clinic
Woodburn, OR56 minutes ago$20.5 - $22.5 per hour
...referrals at the request of the providers, obtains/reviews pre‑authorization/pre‑certification, and coordinates communications with... ...Resolve pre‑certification, registration and case‑related concerns prior to a patient’s appointment. Gather pertinent information from...Work at officeLocal areaRemote workMonday to FridayFlexible hoursOrchid Health
Portland, OR5 days ago- ...in OR, WA, or CA required PGY-1 Residency OR equivalent clinical experience required Minimum 3 years managed care experience (prior authorization, audits, appeals, drug utilization review, etc.) Strong knowledge of clinical pharmacy, pharmacotherapy, and evidence-based...Contract workWork at officeShift workWeekend workDay shift
JobRx, Inc.
Portland, OR2 days ago - ...experience within relevant practice setting Required Skills 3+ Years in a Managed Care Environment Required (meaning dealing with Prior Authorizations, Audits, Appeals, ALJ Court hearings, etc) Experience in writing, including research protocols, medical papers for...Contract workRemote workShift work
Accede Solutions Inc.
Portland, OR4 days ago $17.98 - $32.12 per hour
...improving prescription capture, providing follow-up counseling, and ensuring smooth communication. Key duties include processing prior authorizations, assisting with financial aid, updating clinical data, and supporting administrative tasks. The liaison collaborates closely...Hourly payMinimum wageFull timeWork experience placementWork at officeLocal areaUnitedHealth Group
Portland, OR8 days ago$91.7k - $163.7k
...and outcomes Coordinate care with providers, payers, and manufacturers to ensure therapy access and continuity Oversee prior authorizations and utilization management, ensuring compliance with payer and program requirements Monitor effectiveness and safety of...Minimum wageFull timeWork experience placementLocal areaMonday to FridayUnitedHealth Group
Klamath Falls, OR5 days ago
