Tucson, AZ · On-site
$54K - $116K/yr
Registered Nurse Company: Oak Street Health Role Description: The Center Nurse is a clinical care ... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ...
Tucson, AZ · On-site
$54K - $116K/yr
Registered Nurse Company: Oak Street Health Role Description: The Center Nurse is a clinical care ... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ...
Tucson, AZ · On-site
Registered Nurse Company: Oak Street Health Role Description: The Center Nurse is a clinical care ... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ...
Tucson, AZ · On-site
Registered Nurse Company: Oak Street Health Role Description: The Center Nurse is a clinical care ... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ...
... authorization. Graduate of a baccalaureate nursing program, as recognized by the Accreditation ... Computer skills required, prior experience with electronic medical record systems preferred.
... authorization. Graduate of a baccalaureate nursing program, as recognized by the Accreditation ... Computer skills required, prior experience with electronic medical record systems preferred.
... authorization. Graduate of a baccalaureate nursing program, as recognized by the Accreditation ... Computer skills required, prior experience with electronic medical record systems preferred.
... authorization. Graduate of a baccalaureate nursing program, as recognized by the Accreditation ... Computer skills required, prior experience with electronic medical record systems preferred.
The Intake RN also at times be responsible for the verification and prior authorization of insurance benefits as needed. Qualifications Job Requirements: * Current license to practice nursing in ...
The Intake RN also at times be responsible for the verification and prior authorization of insurance benefits as needed. Qualifications Job Requirements: * Current license to practice nursing in ...
Phoenix, AZ · On-site
$35.62 - $52.99/hr
Navigate Insurance and Authorization Processes - Manage prior authorizations, insurance approvals ... Three (3) years of experience as a RN in an inpatient or outpatient setting or (1) year of RN ...
Phoenix, AZ · On-site
$35.62 - $52.99/hr
Navigate Insurance and Authorization Processes - Manage prior authorizations, insurance approvals ... Three (3) years of experience as a RN in an inpatient or outpatient setting or (1) year of RN ...
$35.62 - $52.99/hr
Navigate Insurance and Authorization Processes - Manage prior authorizations, insurance approvals ... Three (3) years of experience as a RN in an inpatient or outpatient setting or (1) year of RN ...
$35.62 - $52.99/hr
Navigate Insurance and Authorization Processes - Manage prior authorizations, insurance approvals ... Three (3) years of experience as a RN in an inpatient or outpatient setting or (1) year of RN ...
Scottsdale, AZ · On-site
The Intake RN also at times be responsible for the verification and prior authorization of insurance benefits as needed. Qualifications Job Requirements: * Current license to practice nursing in ...
Scottsdale, AZ · On-site
The Intake RN also at times be responsible for the verification and prior authorization of insurance benefits as needed. Qualifications Job Requirements: * Current license to practice nursing in ...
... authorization. Graduate of a baccalaureate nursing program, as recognized by the Accreditation ... Computer skills required, prior experience with electronic medical record systems preferred.
... authorization. Graduate of a baccalaureate nursing program, as recognized by the Accreditation ... Computer skills required, prior experience with electronic medical record systems preferred.
... authorization. Graduate of a baccalaureate nursing program, as recognized by the Accreditation ... Computer skills required, prior experience with electronic medical record systems preferred.
... authorization. Graduate of a baccalaureate nursing program, as recognized by the Accreditation ... Computer skills required, prior experience with electronic medical record systems preferred.
Prescott, AZ · On-site
Registered Nurse (RN) The Registered Nurse (RN) position is located at the Northern Arizona VA ... Not authorized.
Prescott, AZ · On-site
Registered Nurse (RN) The Registered Nurse (RN) position is located at the Northern Arizona VA ... Not authorized.
Prescott, AZ · On-site
EDRP Authorized: This position is eligible for the Education Debt Reduction Program (EDRP), a ... prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
Prescott, AZ · On-site
EDRP Authorized: This position is eligible for the Education Debt Reduction Program (EDRP), a ... prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
... authorization. Graduate of a baccalaureate nursing program, as recognized by the Accreditation ... Computer skills required, prior experience with electronic medical record systems preferred.
... authorization. Graduate of a baccalaureate nursing program, as recognized by the Accreditation ... Computer skills required, prior experience with electronic medical record systems preferred.
... authorization. Graduate of a baccalaureate nursing program, as recognized by the Accreditation ... Computer skills required, prior experience with electronic medical record systems preferred.
... authorization. Graduate of a baccalaureate nursing program, as recognized by the Accreditation ... Computer skills required, prior experience with electronic medical record systems preferred.
... authorization. Graduate of a baccalaureate nursing program, as recognized by the Accreditation ... Computer skills required, prior experience with electronic medical record systems preferred.
... authorization. Graduate of a baccalaureate nursing program, as recognized by the Accreditation ... Computer skills required, prior experience with electronic medical record systems preferred.
... authorization. Graduate of a baccalaureate nursing program, as recognized by the Accreditation ... Computer skills required, prior experience with electronic medical record systems preferred.
... authorization. Graduate of a baccalaureate nursing program, as recognized by the Accreditation ... Computer skills required, prior experience with electronic medical record systems preferred.
... authorization. Graduate of a baccalaureate nursing program, as recognized by the Accreditation ... Computer skills required, prior experience with electronic medical record systems preferred.
... authorization. Graduate of a baccalaureate nursing program, as recognized by the Accreditation ... Computer skills required, prior experience with electronic medical record systems preferred.
Computer skills required, prior experience with electronic medical record systems preferred ... authorization.
Computer skills required, prior experience with electronic medical record systems preferred ... authorization.
... authorization. Graduate of a baccalaureate nursing program, as recognized by the Accreditation ... Computer skills required, prior experience with electronic medical record systems preferred.
... authorization. Graduate of a baccalaureate nursing program, as recognized by the Accreditation ... Computer skills required, prior experience with electronic medical record systems preferred.
Prescott, AZ · On-site
Not authorized. EDRP Authorized : This position is eligible for the Education Debt Reduction ... prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
Prescott, AZ · On-site
Not authorized. EDRP Authorized : This position is eligible for the Education Debt Reduction ... prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
$6.94 - $12.42
0% of jobs
$12.42 - $17.90
0% of jobs
$17.90 - $23.38
4% of jobs
$23.38 - $28.86
18% of jobs
$29.58 is the 25th percentile. Wages below this are outliers.
$28.86 - $34.33
20% of jobs
The median wage is $36.59 / hr.
$34.33 - $39.81
18% of jobs
$44.74 is the 75th percentile. Wages above this are outliers.
$39.81 - $45.29
16% of jobs
$45.29 - $50.77
10% of jobs
$50.77 - $56.25
6% of jobs
$56.25 - $61.73
4% of jobs
$61.73 - $67.20
3% of jobs
$6
$39
$67
| Aspect | Prior Authorization Rn | Medical Coder |
|---|---|---|
| Credentials | RN license, possibly certifications in case management or utilization review | Certification in coding (CPC, CCS), no RN license required |
| Work Environment | Hospitals, insurance companies, healthcare facilities | Medical offices, hospitals, insurance companies |
| Primary Responsibilities | Reviewing and obtaining prior authorizations for treatments and procedures | Translating medical records into coded data for billing and documentation |
While both roles are integral to healthcare administration, the Prior Authorization RN focuses on obtaining approvals for patient care, requiring nursing credentials and clinical knowledge. In contrast, Medical Coders specialize in coding medical records for billing, emphasizing coding certifications. Understanding these differences helps healthcare professionals and job seekers identify the right career path or job opportunity.
A prior authorization RN is a registered nurse who assesses applications for specific treatments, medical procedures, and medications. In this job, you review each request for medical coverage and determine the necessity or potential benefits of the treatment or medicine. You assess patient information and other factors to decide whether or not to authorize coverage. Your duties as a prior authorization RN also include reviewing denials of benefits and seeking additional information that could alter the initial decision. You document your findings for each case and present the evidence along with your decision. It is your job to review the case for each patient thoroughly while following all government regulations and healthcare provider policies.
$54K - $116K/yr
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 6 days ago
7.4
Based on 90 frontline employees who took The Breakroom Quiz
266th of 887 rated healthcare providers
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
Title: Registered Nurse
Company: Oak Street Health
Role Description:
The Center Nurse is a clinical care team member operating within a Value-Based Care model, which prioritizes patient health outcomes and long-term wellness. In this model, the Center Nurse supports the health of patients by utilizing standards, guidelines and pathways for care delivery to prevent complications before they occur. Our Center Nurses drive quality care through clinical assessments, chronic condition management, and collaborating with the care team to reduce avoidable hospitalizations. You will foster an engaging and welcoming environment through effective team communication and delegation, empowering everyone on the team to deliver the best care to our patients.
Our Center Nurses report to the Practice Manager.
Core Responsibilities:
Support patient assessment and prioritization for both walk-in and telephonic triage to ensure patients receive the right level of care and avoid unnecessary hospital visits.
Execute protocol-driven chronic condition management.
Perform skilled nursing procedures including wound care and medication administration (including vaccines).
Provide comprehensive patient and caregiver education regarding chronic conditions and preventative care in person, over the phone, or in group settings.
Conduct medication reviews within nurse-led visits to ensure patient safety and adherence.
Conduct onsite testing (including point-of-care labs, EKGs, and specimen collection) and use patient data to identify and close gaps in preventative screenings, ensuring compliance with state scope of practice.
Review and act upon high-priority abnormal laboratory results in a timely manner to maintain patient safety and continuity of care.
Partner with providers and the interdisciplinary team to manage complex care plans and coordinate weekly transitions for patients moving from the hospital back to the clinic.
Utilize standardized protocols for medication management, prescription renewals and prior authorizations.
Ensures clinical communications are managed, tasks are completed and patient visit encounters are closed in a timely manner.
Delegates to medical assistants and phlebotomists as needed to support patient flow and efficiency.
Performs other related duties as assigned.
Clinical Responsibilities:
Supports the coordination, integration, communication, and implementation of nursing practice and standard operating procedures.
Identifies barriers to optimal care, e.g. physical, cognitive, language, literacy, socioeconomic, cultural, and or behavioral.
Create a welcoming and engaging environment to meet the needs of our patients, communities, families and teams where they are.
Deliver an exceptional patient experience through service, responsiveness and respectful care.
Serve as a key clinical voice in daily care team meetings to align on patient priorities and clinic operations.
Serves as a support and resource for nursing, other clinical staff and providers.
Ensures clinical compliance with Patient Safety initiatives and reporting.
Provides emergency care in accordance with organizational procedure.
Professional Responsibilities:
Engages in self-evaluation and participates in activities to promote own professional growth and development.
Seeks, acquires and maintains current nursing knowledge and competence to fulfill responsibilities as a Center Nurse.
Maintains awareness of current patient centered, evidence-based practice and considers applicable research data to patient care delivery.
Fulfills obligation to identify and report professional misconduct appropriately.
What we're looking for
Required Qualifications:
Active, Unrestricted Registered Nurse Licensure in the state that you reside
BLS or CPR Certification
Fluent written and spoken English language skills.
US work authorization
Electronic Medical Record (EMR) experience
Ability to maintain patient confidentiality and process information in a confidential manner
Ability to assess patients without face-to face interaction, strong communication and assessment skill
Strongly Preferred Qualifications:
Preferred Qualifications:
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$54,095.00 - $116,760.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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Oak Street Health is a rapidly growing company of primary care centers for adults on Medicare in medically-underserved communities where there is little to no quality healthcare. Oak Street's care is based on an entirely new model that is based on value for its patients, not on volume of services. The company is accountable for its patients' health, spending more than twice as long with its patients and taking on the risks and costs of their care.
Health care and social assistance
51 - 200 Employees
Chicago, IL, US
2012
