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- ...Prior Authorization Medical Director Physician Opportunity in the Los Angeles Area Please consider this unique opportunity to join a well... ...organization forward. Requirements MD/DO degree required Remote position, but candidate must live in the greater L.A. area...Remote workPart timeLive inWork from homeRelocation package
Curative
Los Angeles, CA6 days ago - ...Pharmacist Position Our client is looking for multiple Pharmacists with prior authorization experience. This is a remote position so you must have a secure and quiet place to work without interruptions. Responsibilities include evaluating and reviewing all prior authorization...Remote work
ICONMA
Hempstead, NY5 days ago - ...Job Title Location: Fully remote We are looking for a dedicated and passionate professional to join our team. This role will be fully remote and requires someone who can work independently and collaboratively. If you are ready to take on a new challenge and contribute...Remote work
US Tech Solutions
Tampa, FL1 day ago - ...Prior Authorization Pharmacist Location: Remote The main focus of this position is to ensure that all prior authorizations are processed efficiently and accurately. This role requires a deep understanding of insurance policies and the ability to navigate complex...Remote work
US Tech Solutions
Poughkeepsie, NY1 day ago - ...license to join our panel of clinical reviewers. This is a remote, non-clinical opportunity ideal for dental professionals... ...of requested dental treatments and procedures Review prior authorization and appeal cases based on clinical guidelines and standards...Remote workExtra incomeFor contractorsFlexible hours
Dane Street
New York, NY4 days ago - ...Pharmacist Advisor Location: Fully remote Duration: 06+ months contract Note: Ideal candidates must have experience of Prior Authorization, Medicare Part D and Pharmacy Benefit Management experience. Shift Timing: Business Hours are 7am - 8pm EST Monday - Friday...Remote workContract workMonday to FridayShift work
US Tech Solutions
Grand Rapids, MI1 day ago - ...Job Title: Pharmacist Location: Remote Duration: 12+ months contract Job Description: ~ As an RPh Advisor you... ...cases in progress and provides a Clinical decision regarding Prior Authorizations, Tier Exceptions and Non-Formulary requests (50%) Performs...Remote workContract work
US Tech Solutions
Phoenix, AZ5 days ago - ...:00am- 5:pm with rotational weekend and holiday coverage Remote position MA RN licensure required Essential Job Duties... ...treatments and/or procedures. • Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. •...Remote workWork at officeMonday to FridayWeekend work
Molina Healthcare
Long Beach, CA4 days ago - ...Job Profile Summary Location: Fully Remote, TX central time zone preferred, Must have compact state licensure an/or Texas licensure SHIFT: Training 4-5 weeks: Mon - Fri 8AM 5PM CST (No days off) CAMERA ON: Work schedule Mon - Fri 10 AM-7PM CST - 1 hour lunch...Remote workShift work
Axelon
Austin, TX12 hours ago - ...Utilization review nurse Location: 100% Remote in CA Duration: 06 months+ contract... ...Processing pediatric inpatient authorizations, Pediatrics, CCS and UM Works with... ...hospitalization and/or procedures providing prior authorizations and/or concurrent review....Remote workContract workWork at officeShift work
Integrated Resources
Long Beach, CA3 days ago - ...procedures, medical policy guidelines, MCG decision support criteria and CMS regulatory requirements. Process requests for prior authorization of outpatient services in accordance with Customer’s inpatient policy and procedures, medical policy guidelines, MCG decision...Remote job
Campbell Healthcare Solutions
Myrtle Point, ORa month ago $42 - $44 per hour
...Position: Clinical Review Nurse Location: Chicago, IL (Remote) Pay Rate: $42.00-$44.00/hour, based on experience Shift... ...8:30-5 CST; Tues- Sat Position Purpose: Analyzes all prior authorization requests to determine medical necessity of service and...Remote workLocal areaShift workAltaStaff, LLC
Chicago, IL3 days ago- ...with long-term potential and is located in Philadelphia, PA(Remote) . Please review the job description below and contact me... ...Key Requirements and Technology Experience: Key Skills; Prior Authorization, Utilization management, Discharge Planning. Registered Nurse...Remote workContract workLocal areaImmediate start
Pyramid Consulting, Inc
Philadelphia, PA21 days ago - ...We are seeking a Clinical Pharmacist for a fully remote 6 month contract! Location: Fully remote Hours: Training is for... ...responsibilities: Decisioning and processing member prescriptions or prior authorizations through various computer systems ensuring the accuracy of...Remote workContract workWork at officeMonday to FridayShift workNight shift
The Judge Group
Milwaukee, WI4 days ago Physician / Internal Medicine / California / Permanent / Remote Medical Director " Prior Authorizati
$250k - $300k
...We are seeking a Remote Medical Director to replace a retiring physician. This is a long-term, non-clinical role " you will not... ...meetings or trainings. Key Responsibilities Review and approve prior authorization requests using clinical guidelines. Collaborate with...Remote workPermanent employmentLive inIntegrity Healthcare
Northridge, CA5 days ago$25 - $28 per hour
...Customer Service Rep II Duration: 24 months Location: Virtual Connecticut 06355 (Remote) Pay Rate: $25 - 28/hr Patient Access Representative The Prior Authorization Representative is responsible for verifying prior authorization requirements and obtaining authorization...Remote workArtech
Orlando, FL1 day ago$55 per hour
...clinical skills to complete utilization management reviews (Prior authorizations, Coverage Exceptions, Quantity Limit exceptions, and more).... ...Vacation or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated...Remote workPermanent employmentContract workTemporary workActalent
United States4 days ago$55 per hour
...clinical skills to complete utilization management reviews (prior authorizations, coverage exceptions, quantity limit exceptions, and more).... ...Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave) This is a fully remote position....Remote workContract workTemporary workActalent
United States1 day ago- ...Utilization Review Case Manager to work to work remote. The incumbent conducts initial,... ...chart reviews for clinical utilization and authorization. The Utilization Review Case Manager... ...prospective review for services requiring prior authorization as well as timely...Remote workFull timeWorldwide
University of Miami
Richmond, VA1 day ago - ...Clinical Review Nurse - Prior Authorization Work Location: Remote: WA / OR (PST Time Zone). WA can have a compact state license. OR is not a compact state, so they will have to have an OR license or be willing to get one. Assignment Duration: 3 months Work Schedule...Remote workLocal areaShift work
Seattle Staffing
Seattle, WA2 days ago $32 - $40 per hour
...Prior Authorization Nurse This role involves analyzing prior authorization requests to determine the medical necessity of services and the... ...Licensure required. Work Environment: This is a remote position based in Iowa, offered on a contract basis. Job...Remote workContract workTemporary workActalent
Washington DC1 day ago$55 per hour
...clinical skills to complete utilization management reviews (Prior authorizations, Coverage Exceptions, Quantity Limit exceptions, and more).... ...Vacation or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is...Remote workPermanent employmentContract workTemporary workArizona Staffing
United States1 day ago$32 - $40 per hour
...Medical Necessity Reviewer Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of... ...Off/Leave (PTO, Vacation or Sick Leave) This is a fully remote position. Application Deadline: This position is anticipated...Remote workContract workTemporary workActalent
Phoenix, AZ1 day ago- ...provides timely and accurate review and authorization of dental services based on eligibility... ...member eligibility Resolve claim and prior authorization that require UM Review... ...insurance: 1 year (Preferred) Work Location: Remote Equal Opportunity Employer: Race,...Remote workContract workTemporary workWork experience placement
Randstad
River Hills, WI4 days ago $4,000 per month
...signs Processing medication refill requests Managing prior authorizations Acting as a key liaison between patients, families, and... ...required or must obtain within 30 days of start date. Fully remote care team members are exempt from BLS certification...Remote workDaily paidFull timePart timeWork at officeRelocation packageFlexible hoursMaineHealth
Portland, ME3 days ago$55 per hour
...clinical skills to complete utilization management reviews (Prior authorizations, Coverage Exceptions, Quantity Limit exceptions, and more).... ...Vacation or Sick Leave) Workplace Type: This is a fully remote position. Application Deadline: This position is...Remote workContract workTemporary workActalent
United States1 day ago- ...Job Title: Senior Data Analyst Location: Remote Reports To: SVP, Data and Technology Who We Are Icon Health is a... ...Analyze structured healthcare data (e.g., claims, eligibility, prior authorization) to identify trends, monitor KPIs, and support clinical and...Remote jobFull time
Icon Health
Remote4 hours ago $68.64k - $123.16k
...Compliance /Quality will be a good fit for this position. Strong UM Prior Authorization experience highly preferred. Further details to be discussed during our interview process. CA located - Remote position Work hours: Monday - Friday 8:00am - 5:00pm PST CA LVN licensure...Remote workWork experience placementWork at officeMonday to FridayMolina Healthcare
Los Angeles, CA3 days ago$142.8k - $214.2k
...campus, and work-from-home); there may be opportunity fully remote work within a mutually acceptable location. Were looking... ...financial analysis Utilization management (step therapy, prior authorization) Communicate effectively with both internal and external...Remote workContract workTemporary workLocal areaWork from homeFlexible hoursShift workIdaho Staffing
Meridian, ID5 days ago$300 per month
...Job Description Job Description We’re Hiring: Remote Pharmacy Technicians (Full-Time + Weekend PT) Must reside in OH, NC... ...claims Work directly with providers and pharmacies to process prior authorizations Complete outbound service calls for adherence and refill...Remote jobHourly payFull timeWork from homeShift workWeekend workWeekday workPharmacy Synergistics Inc
Camden, SCa month ago
