- University of Miami (Miami, FL)
- …Case Manager RN - Full Time The University of Miami is currently seeking a Prior Authorization Nurse Case Manager. The incumbent purose is to conduct ... + Adhere and perform timely prospective reviews for services requiring prior authorization + Follows the authorization process using established criteria… more
- University of Miami (Miami, FL)
- …complete ongoing reviews for clinical utilization and identifying the need for continued authorization . The Utilization Case Manager coordinates with the Nurse ... team for optimal patient outcomes, while avoiding potential treatment delays and authorization denials. The Utilization Case Manager is accountable for a… more
- Hackensack Meridian Health (Hackensack, NJ)
- …/Radiation Oncology services in the HMH Health care system. This pertains to Prior Authorization for Oncology services, as well as various specialized ... clinical data is submitted to substantiate the request for prior approvals for oncology services. **Responsibilities** A...in order to avoid technical denials for lack of prior authorization . Understand if payer rules governing… more
- Rush University Medical Center (Chicago, IL)
- …site of care. c. Assist in assessing insurance coverage and assist in prior authorization for medications (when necessary) in advance of discharge. Other ... Hematology/ Oncology * Board of Pharmaceutical Specialties Board Certification Board of Oncology Pharmacy Specialty Certification (BCOP) prior to or within 18… more
- MD Anderson Cancer Center (Houston, TX)
- …Preferred: At least 1 year of experience in Advanced Practice Provider role. Prior Oncology experience. **LICENSURE / CERTIFICATION** Required: All of the ... Preferred: At least 1 year of experience in Advanced Practice Provider role. Prior Oncology experience. **LICENSURE / CERTIFICATION** Required: All of the… more
- LifePoint Health (Johnstown, PA)
- CPP Medical Specialties is seeking a full-time Scheduler - CPG Medical Oncology in Johnstown, PA. The Scheduler is responsible for coordinating patient's procedures ... in use of EPIC system for placing orders/prep for case and documenting needed information in appropriate place. This...Responsible for obtaining correct CPT and ICD 10 codes prior to obtaining authorizations for procedures. Will work with… more
- Trinity Health (Hartford, CT)
- …and requesting/verifying patient medical records. This position supports a Urological Oncology Specialty Practice. **What you will do:** + Schedules all inpatient, ... with Advanced Practice Providers (APPs) to schedule and enter case requests for procedures if needed. Ensures patients have...needed. Ensures patients have all required pre-op testing done prior to procedures, ie required labs and other testing… more
- MD Anderson Cancer Center (Houston, TX)
- …to comply with institutional standards, initiatives, and guidelines (ABN's, prior authorization requirements, reimbursement optimization, formulary management, ... learning experiences. * Effectively precepts other trainee-required experiences including oncology forum, research projects, grand rounds, MUEs, etc. * Collaborates… more
- Hackensack Meridian Health (Hackensack, NJ)
- …of studies for feasibility and evaluates potential competition with other protocols prior to submitting study + Reviews study with principal investigator and/or ... consent + Educates study patients concerning informed consent procedures, HIPAA authorization + Documents study patient's medical history including but not limited… more
- Blue KC (KS)
- …available resources to promote optimal, cost-effective outcomes. Transplant only: Provides prior authorization for, coordinates, and individually manages all ... work appropriately. Additional duties for Transplant only: + Provides prior authorization of the transplant and manages...medical policy. Opens case and follows NCQA case management standards. Documents transplant authorization , issues… more