Manager Prior Authorization Jobs Near Me

Utilization review, prior authorization, or managed care experience preferred. * Active OH RN Licensure * Experienced with either Interqual or Milliman Licenses/Certifications: Current RN, required.

Essential Activities and Tasks Authorization Verification and Management - 60% Completes all ... Maintains accurate insurance plan knowledge of all prior authorization requirements (i.e assuring ...

Essential Activities and Tasks Authorization Verification and Management - 60% * Completes all ... Maintains accurate insurance plan knowledge of all prior authorization requirements (i.e. assuring ...

Contacts insurance carriers to obtain benefit coverage, policy limitations, authorization ... Strong time management skills * Ability to work independently with minimal supervision and to ...

Contacts insurance carriers to obtain benefit coverage, policy limitations, authorization ... Strong time management skills * Ability to work independently with minimal supervision and to ...

Contacts insurance carriers to obtain benefit coverage, policy limitations, authorization ... Strong time management skills * Ability to work independently with minimal supervision and to ...

... prior authorizations, and reauthorizations across every payor we serve: Ohio Medicaid waiver programs, managed care plans, the VA, workers' compensation, commercial insurance, long-term care ...

Summary The Care Management Coordinator serves as a cross functional team member providing pathology and prior authorization support to ensure effective treatment, monitoring, and communication ...

Summary The Care Management Coordinator serves as a cross functional team member providing pathology and prior authorization support to ensure effective treatment, monitoring, and communication ...

Summary The Care Management Coordinator serves as a cross functional team member providing pathology and prior authorization support to ensure effective treatment, monitoring, and communication ...

Summary The Care Management Coordinator serves as a cross functional team member providing pathology and prior authorization support to ensure effective treatment, monitoring, and communication ...

Summary The Care Management Coordinator serves as a cross functional team member providing pathology and prior authorization support to ensure effective treatment, monitoring, and communication ...

Provide clinical support for utilization management, prior-authorization criteria, and step-therapy guidelines. What You'll Bring * Education: PharmD or Bachelor of Pharmacy. * Licensure: Active U.S ...

Essential Activities and Tasks Authorization Verification and Management - 60% Completes all ... Maintains accurate insurance plan knowledge of all prior authorization requirements (i.e assuring ...

Essential Activities and Tasks Authorization Verification and Management - 60% Completes all ... Maintains accurate insurance plan knowledge of all prior authorization requirements (i.e assuring ...

... prior authorization or fiscal intervention. Oversees the maintenance and updating of budget ... management oversight 5. Training, Systems Support & Continuous Improvement (10%) Provides training ...

The Manager of Waiver Authorizations ensures compliance with DODD requirements, maintains the ... prior authorization or fiscal intervention. Oversees the maintenance and updating of budget ...

Conducts prior authorization reviews to determine financial responsibility Qualifications * 2 years Inpatient background with Hospital Nursing (Med-Surg, ER) * Well versed in Utilization Management ...

Expert in providing general education on Retail and Specialty Pharmacy drug Prior Authorizations ... Input call activity into customer CRM, as appropriate. * Serve as the local access and ...

Expert in providing general education on Retail and Specialty Pharmacy drug Prior Authorizations ... Input call activity into customer CRM, as appropriate. * Serve as the local access and ...