Collaborates with the coordinators and nurses to process referrals, including answering clinical questions and collecting appropriate clinical/medical data needed to perform clinical assessments and reviews as per the health plan/employer-agreed crit Authorization, Pharmacist, Healthcare, Remote, Cl...
The Utilization Management Prior Authorization team processes accurate and timely prior authorization of designated healthcare services, continuity of care, and access to care clinical review determinations. Successful RN candidate reviews prior auth requests for medical necessity, coding accuracy a...
Ensure that prior authorization requests are completed in a timely fashion to meet contractual requirements and that all reviews are conducted using nationally recognized and evidence-based standards. ...
Triages and prioritizes cases to meet required turn-around times. Requires at least 5 years of prior relevant experience. Prior Authorization experience preferred. ...
Reimbursement and Prior Authorization Specialist located in Spring, Texas. You have experience working with a broad range of payers and have experience coordinating with insurance providers, physicians, and patients to obtain prior authorizations. ...
Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and plan design. Performs and handles inbound and outbound phone calls with coordinators, nurse, physicians, healthcare providers, and/or patients to facilitate prior authorization requ...
Prior Authorizations and UM: Experience at a healthplan or with processing medication prior authorizations. As a full time hybrid Prior Authorization Pharmacy Technician at the Cedars-Sinai Medical Network Foundation, you will assist in supporting the Cedars-Sinai Medical Network pharmacists in the ...
Reimbursement and Prior Authorization Specialist located in Spring, Texas. You have experience working with a broad range of payers and have experience coordinating with insurance providers, physicians, and patients to obtain prior authorizations. ...
Kaiser Permanente is seeking a Registered Nurse (RN) Manager, Labor and Delivery for a nursing job in Los Angeles, California. Registered Nurse License (California). Leadership Experience will be permissible for Kaiser Permanente internal applicants only and is defined by the following criteria: Dem...
Registered Nurse - RN - ER (Emergency Room). Registered Nurse - RN - ER (Emergency Room). CAREERSTAFF BENEFITS FOR THE RN:. ...
Kaiser Permanente is seeking a Registered Nurse (RN) NICU - Neonatal Intensive Care for a nursing job in Los Angeles, California. The Registered Nurse demonstrates proficiency by exhibiting the following skills, competencies, and behaviors:. Ensures optimal pain control and patient comfort; identifi...
TravelNurseSource is working with Trustaff to find a qualified OR RN in Lynwood, California, 90262!. As an Operating Room Nurse, or OR RN, you'll be responsible for patient care in the preoperative, intraoperative, and postoperative phases of a patient's surgical experience. Travel nurses work for a...
TravelNurseSource is working with Atlas MedStaff to find a qualified Cath Lab RN in Inglewood, California, 90301!. ...
Staff pharmacist job at a community hospital in Whittier. CA Pharmacist license, PGYI, hospital experience, good attitude and people skills. ...
FlexCare Medical Staffing is seeking an experienced Pediatric Intensive Care Unit Registered Nurse for an exciting Travel Nursing job in Long Beach, CA. Additionally, the review may consider the potential impact on the nurse's ability to meet licensing and regulatory requirements as mandated by rele...
Axis Medical Staffing is seeking an experienced Intensive Care Unit Registered Nurse for an exciting Travel Nursing job in Garden Grove, CA. Since 2004, Axis Medical Staffing has excelled in connecting adventurous travel nurses with amazing opportunities throughout the country, setting us apart from...
Ventura MedStaff is seeking an experienced Neonatal Intensive Care Unit Registered Nurse for an exciting Travel Nursing job in Lynwood, CA. ...
Meda Health is seeking an experienced Labor and Delivery Registered Nurse for an exciting Travel Nursing job in Los Angeles, CA. ...
Ventura MedStaff is seeking an experienced Interventional Radiology Registered Nurse for an exciting Travel Nursing job in Los Angeles, CA. ...
TRS Healthcare is seeking an experienced Intensive Care Unit Registered Nurse for an exciting Travel Nursing job in Garden Grove, CA. TRS Healthcare is seeking a Registered Nurse that is licensed in CA to work in the specialty area of Intensive Care Unit. The Registered Nurse assumes responsibility ...
TRS Healthcare is seeking an experienced Emergency Room Registered Nurse for an exciting Travel Nursing job in Los Angeles, CA. TRS Healthcare is seeking a Registered Nurse that is licensed in CA to work in the specialty area of Emergency Room. The Registered Nurse assumes responsibility and account...
Family owned and operated since 1977, our Company offers more than 4,000 products to a variety of customers in both the foodservice and retail channels. Excellent customer service and communication skills. Minimum of 2-3 years inside sales/customer services preferred. Assist customers with product a...
CAP seeks a Senior Claims Specialist, for its Orange County office, to perform technical and administrative duties to manage assigned claim files; assumes increased workload of highly complex claims. Participates in the continued training and supervision of Claims Specialist I and II’s. Manage medic...
Are you looking for more out of your pharmacy career? Do you want to work with a pharmacy operations team that is interested in your development and the patient experience as well as the success of our business? Raley’s pharmacy is currently seeking pharmacy team leaders who can guide a team of phar...
Kaiser Permanente is seeking a Registered Nurse (RN) Case Management for a nursing job in Downey, California. Registered Nurse License (California). ...