Pittsburgh, PA · Remote
$54.50 - $65.50/hr
Pharmacist needed for Remote / Work From Home Position! Multiple openings with aSeptember Start ... review all prior authorization requests and render coverage determinations based on clinical ...
Pittsburgh, PA · Remote
$54.50 - $65.50/hr
Pharmacist needed for Remote / Work From Home Position! Multiple openings with aSeptember Start ... review all prior authorization requests and render coverage determinations based on clinical ...
Pittsburgh, PA · Remote
$54.50 - $65.50/hr
Pharmacist needed for Remote / Work From Home Position! Multiple openings with aSeptember Start ... review all prior authorization requests and render coverage determinations based on clinical ...
Pittsburgh, PA · Remote
$54.50 - $65.50/hr
Pharmacist needed for Remote / Work From Home Position! Multiple openings with aSeptember Start ... review all prior authorization requests and render coverage determinations based on clinical ...
Pittsburgh, PA · Remote
$122K - $142K/yr
Manage the first line clinical review of prior authorization requests on behalf of physicians and ... As this position is remote, please understand that we do have the ability to have staff report to ...
Pittsburgh, PA · Remote
$122K - $142K/yr
Manage the first line clinical review of prior authorization requests on behalf of physicians and ... As this position is remote, please understand that we do have the ability to have staff report to ...
Pittsburgh, PA · On-site +1
$20 - $30.55/hr
Manage the first line clinical review of prior authorization requests on behalf of physicians and ... As this position is remote, please understand that we do have the ability to have staff report to ...
Pittsburgh, PA · On-site +1
$20 - $30.55/hr
Manage the first line clinical review of prior authorization requests on behalf of physicians and ... As this position is remote, please understand that we do have the ability to have staff report to ...
Pittsburgh, PA · Remote
$17.50 - $21.25/hr
Remote - supporting Northeast (EST Zone) ???? About the Role Shields Health Solutions is seeking a ... prior authorization completion, and financial assistance support * Provide ongoing performance ...
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Pittsburgh, PA · Remote
$17.50 - $21.25/hr
Remote - supporting Northeast (EST Zone) ???? About the Role Shields Health Solutions is seeking a ... prior authorization completion, and financial assistance support * Provide ongoing performance ...
Pittsburgh, PA · On-site +1
$40 - $42/hr
Remote work - enjoy the convenience and balance of working from home * Autonomy and flexibility in ... Make authorization determinations by approving, modifying, or denying service requests within RN ...
Pittsburgh, PA · On-site +1
$40 - $42/hr
Remote work - enjoy the convenience and balance of working from home * Autonomy and flexibility in ... Make authorization determinations by approving, modifying, or denying service requests within RN ...
Pittsburgh, PA · Remote
$15.75 - $19.25/hr
Assists physicians in the prior authorization process including initiation of prior authorizations. * May be cross-trained and/or work on Major Medical (MM) and Specialized PBM Plans. * Verifies ...
Pittsburgh, PA · Remote
$15.75 - $19.25/hr
Assists physicians in the prior authorization process including initiation of prior authorizations. * May be cross-trained and/or work on Major Medical (MM) and Specialized PBM Plans. * Verifies ...
Pittsburgh, PA · Remote
$15.75 - $19.25/hr
Assists physicians in the prior authorization process including initiation of prior authorizations. * May be cross-trained and/or work on Major Medical (MM) and Specialized PBM Plans. * Verifies ...
Pittsburgh, PA · Remote
$15.75 - $19.25/hr
Assists physicians in the prior authorization process including initiation of prior authorizations. * May be cross-trained and/or work on Major Medical (MM) and Specialized PBM Plans. * Verifies ...
Greensburg, PA · Remote
$34.25 - $41.25/hr
Registered Nurse Assessment Coordinator (RNAC) coordinates the MDS and Care Planning process to ensure timely and accurate submission with the Interdisciplinary team. * This is a PRN Remote position
New
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Greensburg, PA · Remote
$34.25 - $41.25/hr
Registered Nurse Assessment Coordinator (RNAC) coordinates the MDS and Care Planning process to ensure timely and accurate submission with the Interdisciplinary team. * This is a PRN Remote position
New
Pittsburgh, PA · Remote
$50 - $55/hr
We are seeking a dedicated Registered Nurse for a full-time position providing home health and ... Prior experience using HomeCare HomeBase (HCHB) software is strongly preferred. * Specialized Care ...
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Pittsburgh, PA · Remote
$50 - $55/hr
We are seeking a dedicated Registered Nurse for a full-time position providing home health and ... Prior experience using HomeCare HomeBase (HCHB) software is strongly preferred. * Specialized Care ...
Beaver, PA · Remote
$29.29 - $34.02/hr
Remote / Community-Based (Primarily field-based traveling within the community, with remaining ... Prior exposure to substance use disorders/SUD is highly preferred). * Technical Compliance:
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Beaver, PA · Remote
$29.29 - $34.02/hr
Remote / Community-Based (Primarily field-based traveling within the community, with remaining ... Prior exposure to substance use disorders/SUD is highly preferred). * Technical Compliance:
Butler, PA · On-site +1
$33/hr
Overview Registered Nurse RN Home Care - $1,000 Sign On Bonus (to be paid throughout the first year ... Prior home health care, hospice, psychiatric and/or mental health nursing experience preferred.
Butler, PA · On-site +1
$33/hr
Overview Registered Nurse RN Home Care - $1,000 Sign On Bonus (to be paid throughout the first year ... Prior home health care, hospice, psychiatric and/or mental health nursing experience preferred.
Butler, PA · On-site +1
$33/hr
Overview Overview Registered Nurse RN Home Care - $6,000 Sign On Bonus (to be paid throughout the ... Prior home health care, hospice, psychiatric and/or mental health nursing experience preferred.
Butler, PA · On-site +1
$33/hr
Overview Overview Registered Nurse RN Home Care - $6,000 Sign On Bonus (to be paid throughout the ... Prior home health care, hospice, psychiatric and/or mental health nursing experience preferred.
Pittsburgh, PA · Remote
$29.25 - $38.75/hr
Active Registered Nurse (RN) or Licensed Practical Nurse (LPN/LVN) license. * (compacted license ... Prior HEDIS, medical record retrieval, chart review, or chart abstraction experience preferred.
Pittsburgh, PA · Remote
$29.25 - $38.75/hr
Active Registered Nurse (RN) or Licensed Practical Nurse (LPN/LVN) license. * (compacted license ... Prior HEDIS, medical record retrieval, chart review, or chart abstraction experience preferred.
Aspinwall, PA · On-site +1
$71K - $147K/yr
Not Authorized Telework: Not Authorized Virtual: This is not a virtual position. Relocation ... prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
Aspinwall, PA · On-site +1
$71K - $147K/yr
Not Authorized Telework: Not Authorized Virtual: This is not a virtual position. Relocation ... prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
Pittsburgh, PA · Remote
$122K - $142K/yr
... Formulary, Prior Authorization, and other clinical programs. This role is responsible for the ... Registration as a registered pharmacist (RPh), in home state. Continuing Education requirements met ...
Pittsburgh, PA · Remote
$122K - $142K/yr
... Formulary, Prior Authorization, and other clinical programs. This role is responsible for the ... Registration as a registered pharmacist (RPh), in home state. Continuing Education requirements met ...
Pittsburgh, PA · On-site +1
$51.48 - $87.36/hr
... Formulary, Prior Authorization, and other clinical programs. This role is responsible for the ... Registration as a registered pharmacist (RPh), in home state. Continuing Education requirements met ...
Pittsburgh, PA · On-site +1
$51.48 - $87.36/hr
... Formulary, Prior Authorization, and other clinical programs. This role is responsible for the ... Registration as a registered pharmacist (RPh), in home state. Continuing Education requirements met ...
Pittsburgh, PA · On-site +1
$75K - $96K/yr
... Insurance RN Field Case Manager This Field Case Manager will cover West Pittsburg, PA region ... remote work environment that allows face to face interaction with injured workers and medical ...
Pittsburgh, PA · On-site +1
$75K - $96K/yr
... Insurance RN Field Case Manager This Field Case Manager will cover West Pittsburg, PA region ... remote work environment that allows face to face interaction with injured workers and medical ...
Canonsburg, PA · On-site +1
$71K - $91K/yr
... Insurance RN Field Case Manager This Field Case Manager will cover West Pittsburg, PA region ... remote work environment that allows face to face interaction with injured workers and medical ...
Canonsburg, PA · On-site +1
$71K - $91K/yr
... Insurance RN Field Case Manager This Field Case Manager will cover West Pittsburg, PA region ... remote work environment that allows face to face interaction with injured workers and medical ...
Pittsburgh, PA · On-site +1
$75K - $96K/yr
... Insurance RN Field Case Manager This Field Case Manager will cover West Pittsburg, PA region ... remote work environment that allows face to face interaction with injured workers and medical ...
Pittsburgh, PA · On-site +1
$75K - $96K/yr
... Insurance RN Field Case Manager This Field Case Manager will cover West Pittsburg, PA region ... remote work environment that allows face to face interaction with injured workers and medical ...
$7.23 - $12.94
0% of jobs
$12.94 - $18.65
0% of jobs
$18.65 - $24.36
4% of jobs
$24.36 - $30.06
18% of jobs
$30.81 is the 25th percentile. Wages below this are outliers.
$30.06 - $35.77
20% of jobs
The median wage is $38.12 / hr.
$35.77 - $41.48
18% of jobs
$46.61 is the 75th percentile. Wages above this are outliers.
$41.48 - $47.18
16% of jobs
$47.18 - $52.89
10% of jobs
$52.89 - $58.60
6% of jobs
$58.60 - $64.30
4% of jobs
$64.30 - $70.01
3% of jobs
$7
$41
$70
| 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.
For Remote Prior Authorization Rn jobs in Pittsburgh, PA, the most frequently searched job titles are:
The top searched job categories for Remote Prior Authorization Rn jobs in Pittsburgh, PA are:
Cities near Pittsburgh, PA with the most Remote Prior Authorization Rn job openings:
$54.50 - $65.50/hr
Full-time
Retirement
Posted 24 days ago
Pharmacist needed for Remote / Work From Home Position! Multiple openings with aSeptember Start Dates! Pay Rate: 53.00 per hour depending on what role we get you in for! 3 Different Departments hiring during this time of year - Here is the options: 2 Opening: 8am to 8pm EST/CST - 8hours per day M-F or 7am-330p EST/CST rotating weekends (September 8th and September 28th Start Dates - Hottest Openings) 1 Opening: Monday - Friday 930am - 6pm 1 Opening: (Sun-Thurs or Tues-Sat): 10:30am-7pm CST or 11am-7:30pm CST or 11:30am-8pm CST Job Description: Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and plan design.
Includes verifying insurance coverage and eligibility, interpreting clinical guideline criteria, consulting physicians and other healthcare providers, and appropriately utilizing clinical knowledge and resources while complying with department protocols. One of the crucial responsibilities is to guarantee that the decisions regarding cases are conveyed promptly and efficiently to all the healthcare providers, health plans/employers, patients, and other healthcare professionals following agreed-upon approval & denial management processes.
As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy benefits. You will be responsible for ensuring cases are accurately set up for our members, review clinical information for decisioning the request, performing outreach to providers for more information when needed, and ensuring accurate decisions that comply with compendia and Medicare guidance and timelines.
This is a great opportunity to initiate a career with a leading healthcare company by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines, while promoting a best-in-class service experience.
Job Requirements:
Must be licensed Pharmacist in the State you Reside in Looking for Pharmacist with Prior Authorization Experience - PBM! (Not retail experience) Must have home office/ability to work from home with no distractions and plug in ethernet Benefits/401k Opportunity! Benefits are available to full-time employees after 90 days of employment A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates Please apply now to these Pharmacist Openings! - Jared Petrill
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A-Line Staffing Solutions is an established full-service recruiting and staffing provider that operates in the industry of human resources and recruitment. Based in Utica, Michigan, A-Line Staffing Solutions has been committed to its mission of providing innovative and effective workforce solutions since its foundation. The company specializes in providing high-quality staffing solutions for a range of disciplines, including Information Technology, Professional, Administrative, Healthcare, and more. A-Line prides itself on its ability to offer comprehensive and tailored staffing solutions in line with the varying needs of different businesses, which has played a crucial role in the company's growth and success.
Recruiting and staffing services
201 - 500 Employees
Utica, MI, US
2004
