... work remote. The incumbent conducts initial, concurrent and retrospective chart reviews for ... Adhere and perform timely prospective review for services requiring prior authorization as well as ...
... work remote. The incumbent conducts initial, concurrent and retrospective chart reviews for ... Adhere and perform timely prospective review for services requiring prior authorization as well as ...
... work remote. The incumbent conducts initial, concurrent and retrospective chart reviews for ... Adhere and perform timely prospective review for services requiring prior authorization as well as ...
... work remote. The incumbent conducts initial, concurrent and retrospective chart reviews for ... Adhere and perform timely prospective review for services requiring prior authorization as well as ...
... prior authorization, complex pre-payment medical review or post-payment medical review. ESSENTIAL ... Valid unrestricted Registered Nurse (RN) license PREFERRED QUALIFICATIONS * Inpatient ...
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... prior authorization, complex pre-payment medical review or post-payment medical review. ESSENTIAL ... Valid unrestricted Registered Nurse (RN) license PREFERRED QUALIFICATIONS * Inpatient ...
Remote Travel Nurse Trainer - Licensed RN or APRN
Saint Petersburg, FL · On-site +1
$22 - $27/hr
Remote Travel Nurse Trainer - Licensed RN or APRN Type: Full-Time, Travel Nursing Who You Are You are a licensed nurse with a passion for aesthetics and education. You thrive in a remote-first ...
Remote Travel Nurse Trainer - Licensed RN or APRN
Saint Petersburg, FL · On-site +1
$22 - $27/hr
Remote Travel Nurse Trainer - Licensed RN or APRN Type: Full-Time, Travel Nursing Who You Are You are a licensed nurse with a passion for aesthetics and education. You thrive in a remote-first ...
Remote Travel Nurse Trainer - Licensed RN or APRN
Saint Petersburg, FL · On-site +1
$22 - $27/hr
Remote Travel Nurse Trainer - Licensed RN or APRN Type: Full-Time, Travel Nursing Who You Are You are a licensed nurse with a passion for aesthetics and education. You thrive in a remote-first ...
Remote Travel Nurse Trainer - Licensed RN or APRN
Saint Petersburg, FL · On-site +1
$22 - $27/hr
Remote Travel Nurse Trainer - Licensed RN or APRN Type: Full-Time, Travel Nursing Who You Are You are a licensed nurse with a passion for aesthetics and education. You thrive in a remote-first ...
Registered Nurse (RN)
Fort Myers, FL · On-site +1
Summary Millennium Physician Group Remote Triage Nurse (RN) plays a vital role in healthcare settings, providing timely and efficient support to patients through remote communication channels. You ...
Registered Nurse (RN)
Fort Myers, FL · On-site +1
Summary Millennium Physician Group Remote Triage Nurse (RN) plays a vital role in healthcare settings, providing timely and efficient support to patients through remote communication channels. You ...
Registered Nurse (RN)
Fort Myers, FL · Remote
Summary Millennium Physician Group Remote Triage Nurse (RN) plays a vital role in healthcare settings, providing timely and efficient support to patients through remote communication channels. You ...
Registered Nurse (RN)
Fort Myers, FL · Remote
Summary Millennium Physician Group Remote Triage Nurse (RN) plays a vital role in healthcare settings, providing timely and efficient support to patients through remote communication channels. You ...
Outpatient Mental Health Registered Nurse
Bay Pines, FL · On-site +1
$75K - $148K/yr
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.
Outpatient Mental Health Registered Nurse
Bay Pines, FL · On-site +1
$75K - $148K/yr
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.
Registered Nurse Trainer
Orlando, FL · On-site +1
$22 - $27/hr
Registered Nurse Trainer Employment Type: Full-Time Work Schedule: 80% Remote / 20% Travel Role Overview We are looking for a licensed RN or APRN with experience in aesthetics or med spa settings to ...
Registered Nurse Trainer
Orlando, FL · On-site +1
$22 - $27/hr
Registered Nurse Trainer Employment Type: Full-Time Work Schedule: 80% Remote / 20% Travel Role Overview We are looking for a licensed RN or APRN with experience in aesthetics or med spa settings to ...
Registered Nurse Trainer
Orlando, FL · On-site +1
$22 - $27/hr
Registered Nurse Trainer Employment Type: Full-Time Work Schedule: 80% Remote / 20% Travel Role Overview We are looking for a licensed RN or APRN with experience in aesthetics or med spa settings to ...
Registered Nurse Trainer
Orlando, FL · On-site +1
$22 - $27/hr
Registered Nurse Trainer Employment Type: Full-Time Work Schedule: 80% Remote / 20% Travel Role Overview We are looking for a licensed RN or APRN with experience in aesthetics or med spa settings to ...
Registered Nurse-Outpatient Primary Care
The Villages, FL · On-site +1
$74K - $140K/yr
Not Authorized Permanent Change of Station (PCS) : Not Authorized Requirements Help Conditions of ... prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
Registered Nurse-Outpatient Primary Care
The Villages, FL · On-site +1
$74K - $140K/yr
Not Authorized Permanent Change of Station (PCS) : Not Authorized Requirements Help Conditions of ... prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
Registered Nurse- Cardiology
Gainesville, FL · On-site +1
$74K - $140K/yr
Completes assessment of cardiology patients prior to appointments based upon evaluation and ... Not Authorized Permanent Change of Station (PCS) : Not Authorized Requirements Help Conditions of ...
Registered Nurse- Cardiology
Gainesville, FL · On-site +1
$74K - $140K/yr
Completes assessment of cardiology patients prior to appointments based upon evaluation and ... Not Authorized Permanent Change of Station (PCS) : Not Authorized Requirements Help Conditions of ...
... Review, Prior Authorization, Informatics, etc.). * Responsible for oversight of stakeholder ... Active and current Registered Nurse (RN) license PREFERRED QUALIFICATIONS * Bachelor of Science ...
New
Quick apply
... Review, Prior Authorization, Informatics, etc.). * Responsible for oversight of stakeholder ... Active and current Registered Nurse (RN) license PREFERRED QUALIFICATIONS * Bachelor of Science ...
New
Travel Nurse Trainer - Remote with Occasional Travel
Orlando, FL · On-site +1
$22 - $27/mo
Travel Nurse Trainer (RN/APRN) - Remote with Occasional Travel Employment Type: Full-Time | Work Schedule: 80% Remote / 20% Travel Role Overview We are seeking a licensed RN or APRN with experience ...
Travel Nurse Trainer - Remote with Occasional Travel
Orlando, FL · On-site +1
$22 - $27/mo
Travel Nurse Trainer (RN/APRN) - Remote with Occasional Travel Employment Type: Full-Time | Work Schedule: 80% Remote / 20% Travel Role Overview We are seeking a licensed RN or APRN with experience ...
Travel Nurse Trainer - Remote with Occasional Travel
Orlando, FL · On-site +1
$22 - $27/hr
Travel Nurse Trainer (RN/APRN) - Remote with Occasional Travel Employment Type: Full-Time | Work Schedule: 80% Remote / 20% Travel Role Overview We are seeking a licensed RN or APRN with experience ...
Travel Nurse Trainer - Remote with Occasional Travel
Orlando, FL · On-site +1
$22 - $27/hr
Travel Nurse Trainer (RN/APRN) - Remote with Occasional Travel Employment Type: Full-Time | Work Schedule: 80% Remote / 20% Travel Role Overview We are seeking a licensed RN or APRN with experience ...
Travel Nurse Trainer
Sarasota, FL · On-site +1
$22 - $27/hr
Travel Nurse Trainer (RN/APRN) - Join Our Wellness Network Top Highlights: * 80% remote | 20% travel * First 2 weeks on-site orientation * Create training modules and conduct virtual sessions
Travel Nurse Trainer
Sarasota, FL · On-site +1
$22 - $27/hr
Travel Nurse Trainer (RN/APRN) - Join Our Wellness Network Top Highlights: * 80% remote | 20% travel * First 2 weeks on-site orientation * Create training modules and conduct virtual sessions
Travel Nurse Trainer
Sarasota, FL · On-site +1
$22 - $27/hr
Travel Nurse Trainer (RN/APRN) - Join Our Wellness Network Top Highlights: * 80% remote | 20% travel * First 2 weeks on-site orientation * Create training modules and conduct virtual sessions
Travel Nurse Trainer
Sarasota, FL · On-site +1
$22 - $27/hr
Travel Nurse Trainer (RN/APRN) - Join Our Wellness Network Top Highlights: * 80% remote | 20% travel * First 2 weeks on-site orientation * Create training modules and conduct virtual sessions
Benefits All Remote Hospice Triage RNs, once trained to their originally assigned team are paid $25 per hour. There are multiple opportunities to increase the hourly rate with the potential to earn ...
Benefits All Remote Hospice Triage RNs, once trained to their originally assigned team are paid $25 per hour. There are multiple opportunities to increase the hourly rate with the potential to earn ...
Benefits All Remote Hospice Triage RNs, once trained to their originally assigned team are paid $25 per hour. There are multiple opportunities to increase the hourly rate with the potential to earn ...
Benefits All Remote Hospice Triage RNs, once trained to their originally assigned team are paid $25 per hour. There are multiple opportunities to increase the hourly rate with the potential to earn ...
Obtain prior authorizations and pre-certifications for in-home nursing services for a dedicated ... Hybrid/Remote What we Offer: * A supportive and collaborative work environment. * Opportunity to ...
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Obtain prior authorizations and pre-certifications for in-home nursing services for a dedicated ... Hybrid/Remote What we Offer: * A supportive and collaborative work environment. * Opportunity to ...
Remote Prior Authorization Rn information
What is the difference between Remote Prior Authorization Rn vs Remote Medical Coder?
| Aspect | Remote Prior Authorization Rn | Remote Medical Coder |
|---|---|---|
| Credentials | RN license, certification in case management or utilization review | Certification in coding (CPC, CCS), high school diploma or equivalent |
| Work Environment | Healthcare facilities, insurance companies, telehealth | Medical offices, insurance companies, remote coding platforms |
| Industry Usage | Utilization review, patient authorization, insurance approval | Medical record review, billing, coding for insurance claims |
Remote Prior Authorization Rns focus on reviewing patient information to approve treatments, while Remote Medical Coders translate medical records into codes for billing. Both roles require healthcare knowledge but serve different functions within the healthcare industry.
What are popular job titles related to Remote Prior Authorization Rn jobs in Florida?
For Remote Prior Authorization Rn jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Remote Prior Authorization Rn jobs in Florida look for?
The top searched job categories for Remote Prior Authorization Rn jobs in Florida are:
What cities in Florida are hiring for Remote Prior Authorization Rn jobs?
Cities in Florida with the most Remote Prior Authorization Rn job openings:

Oncology Prior Authorization Case Manager, Non-RN - Remote
Miami, FL • On-site, Remote
Full-time
Medical, Dental
Re-posted 27 days ago
University Of Miami rating
7.7
Based on 52 frontline employees who took The Breakroom Quiz
Job description
If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position, please review this tip sheet.
The University of Miami Health System Department of UMHC SCCC Business Operations has an exciting opportunity for a full time Utilization Review Case Manager to work to work remote. The incumbent conducts initial, concurrent and retrospective chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare team for optimal and efficient patient outcomes, while avoiding treatment delays and authorization denials. They are accountable for a designated patient caseload and provide intervention and coordination to decrease avoidable delays, at all times they provide communication of progress and or determination to the clinical team and or the patient. He/she monitors care and acts as a liaison between patient/family, healthcare personnel, and insurers. Evaluates the needs of the patient, the resources available, and recommends and facilitates for the best outcome to meet ongoing patient needs that encourages compliance with medical advice.
CORE FUNCTIONS:
- Adhere and perform timely prospective review for services requiring prior authorization as well as timely concurrent review for continuation of care services
- Follows the authorization process using established criteria as set forth by the payer or clinical guidelines
- Accurate review of coverage benefits and payer policy limitations to determine appropriateness of requested services
- Refers to the treatment plan for clinical reviews in accordance with established criteria and guidelines
- Facilitates communication of denials and or Peer to Peer requests between payers and the healthcare team
- Identifies potential delays in treatment or inappropriate utilization by reviewing the treatment plan, serves as a resource to provide education regarding payer policies and assists with coordination of alternative treatment options
- Ensures and Maintains effective communication regarding authorization status and determination to the clinical team and on occasion the patient.
- Proactive communication with leadership regarding barriers and or potential delays in care Identifies opportunities for expedited requests and prioritizes caseload accordingly
- Maintains knowledge regarding payer reimbursement policies and clinical guidelines.
- This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary.
CORE QUALIFICATIONS:
Education:
Bachelor's degree in relevant field; or equivalent
Experience:
Minimum of 2 years of relevant experience
Oncology - Preferred
Any relevant education, certifications and/or work experience may be considered
The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.
UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for.
The University of Miami is an Equal Opportunity Employer. Applicants and employees are protected from discrimination based on certain categories protected by Federal law.
Job Status:
Full time
Employee Type:
Staff
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About University of Miami
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The University of Miami, located in the beautiful Coral Gables, Florida, is a comprehensive, private research institution in the United States. Operating within the higher education industry, the institution offers a multitude of degree programs spanning over 180 majors and program through its 12 colleges. The University was founded in 1925 with the mission to disseminate knowledge, transform lives, and change the world - a mission it has held faithfully to this day. Notably, the University of Miami has gained global recognition for its commitment to research and innovation, with over $324 million in research and sponsored project funding awarded annually.
Industry
Colleges, universities, and professional schools
Company size
10,000+ Employees
Headquarters location
Coral Gables, FL, US
Year founded
1925