One to three (1-3) years recent care management prior authorization experience* Graduate of an accredited school of nursing (Bachelors of Science in Nursing and/or Master's level degree preferred)* Experience working with health plan auditors preferred. ...
JOB TITLE: CARE REVIEW CLINICIAN, PRIOR AUTHORIZATION (REGISTERED NURSE, OR LVN)For this position we are seeking a Nurse with previous experience in Prior Auth Utilization Management and knowledge of Interqual or MCG guidelines. Conducts prior authorization reviews to determine financial responsibil...
Reimbursement Specialist - Prior Authorization. Reimbursement and Prior Authorization Specialist located in Spring, Texas. You should have moderate Excel skills and experience working with a broad range of payers and coordinating with insurance providers, physicians, and patients to obtain prior aut...
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 ...
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. ...
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. ...
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. ...
Vetted Health is actively hiring Travel Registered Nurses (RNs) for 13-week assignments across the United States. Minimum 1 year of Registered Nursing experience required. ...
Are you ready to take your pharmacy career to the next level? Step into the spotlight and join our team of exceptional professionals at a respected medical facility! We're on the hunt for an outstanding candidate to fill the role of Hospital Staff Pharmacist, where you'll have the opportunity to hon...
TravelNurseSource is working with Trustaff to find a qualified ER/Trauma RN in Moreno Valley, California, 92551!. ER nurses must be able to recognize and effectively treat life-threatening conditions, so be ready to work as part of a close-knit team in a fast-paced environment. Travel nurses work fo...
Meda Health is seeking an experienced Intensive Care Unit Registered Nurse for an exciting Travel Nursing job in Redlands, CA. ...
Medical Solutions is seeking an experienced Labor and Delivery Registered Nurse for an exciting Travel Nursing job in Moreno Valley, CA. This L&D (Labor and Delivery) in RN (Registered Nurse) job in Moreno Valley, CA could be the next chapter in your story of personal and professional growth. Nu...
Epic Travel Staffing is seeking an experienced Emergency Room Registered Nurse for an exciting Travel Nursing job in Moreno Valley, CA. Our exclusive job openings can only be found through Epic Travel Staffing, where we specialize in providing staffing solutions for Nurse, Allied, and Interim Manage...
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...
We are looking for a Weekend Home Health Registered Nurse to join our fast-growing team. POSITION: Registered Nurse (Home Health). Current and unrestricted California Registered Nurse license. We strive to improve the quality of your life with our team of specially trained nurses, therapists an...
Specific components of the Registered Nurse role include demonstrating clinical competence; managing patient care; improving quality of care; establishing professional relationships and utilizing professional skills; fulfilling responsibilities of the role of the hospital; and developing clinical ex...
This registered professional nurse will function within the full scope of RN licensure, according to the California Nursing Practice Act. Sufficient education to obtain a valid California RN license. Current valid California RN license. MarinHealth is already realizing the benefits of impressive gro...
Public Health Nurse I: Under close supervision, to perform public health nursing, teaching and health guidance services in homes, clinics, and a wide variety of community settings in connection with health promotion and the prevention and control of Nurse, Registered Nurse, Public Health, Health, R...
TinkBird Healthcare Staffing is a comprehensive healthcare recruiting and job placement firm for travel nursing and allied health positions.We offer up to 13-week contracts, temporary-to-hire and permanent placements.We are delighted to inform you that we are expanding across the country, and we req...
MSN and 2 years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Master's degree in *related field with BSN and two years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimensio...
The PACE Claims Examiner/Data Specialist is responsible for processing professional and hospital capitated full risk claims in accordance with the individual provider contract and Medicare and Medi-Cal billing guidelines and processes claims. ...
The Clinical Pharmacist-Inpt is responsible for analyzing, dispensing, compounding, monitoring, and recommending appropriate pharmaceutical care for patients of all ages. Assists in the training and education of new pharmacists, technicians, students, and residents. PharmD is required if Pharmacist ...
The Clinical Pharmacist-Inpt is responsible for analyzing, dispensing, compounding, monitoring, and recommending appropriate pharmaceutical care for patients of all ages. Assists in the training and education of new pharmacists, technicians, students, and residents. PharmD is required if Pharmacist ...
The Clinical Pharmacist- Outpatient (Outpt) supervises clerks, technicians, interns and students to ensure that the needs of neonatal, pediatric and adult patients are met. Current California Pharmacist License required. ...
Job Summary: The PACE Claims Examiner/Data Specialist is responsible for processing professional and hospital capitated full risk claims in accordance with the individual provider contract and Medicare and Medi-Cal billing guidelines and processes claims. ...