Healthcare Authorization Coordinator

Job Title: Prior Authorization Coordinator RNJob Type: Full-timeLocation: RemoteAbout Us:At Advanced Medical Manage, we are dedicated to providing high-quality healthcare services to our members. We are seeking an experienced Prior Authorization Coordinator RN to join our team.Job Summary:The Prior Authorization Coordinator RN will be responsible for...

Key ResponsibilitiesConduct prior authorization reviews to determine financial responsibility for Molina Healthcare and its members.Analyze clinical service requests against evidence-based clinical guidelines.Collaborate with multidisciplinary teams to promote the Molina Care Model.

In this role, you will have the opportunity to make a meaningful impact on the lives of our members. As a Prior Authorization Registered Nurse, you will be responsible for ensuring that patients receive quality care that is medically appropriate and cost-effective.

Job OverviewThis position is responsible for conducting prospective and retrospective reviews of requests for service authorizations to ensure continuity and coordination of care.Key Responsibilities:Determine compliance with established medical necessity criteria using Milliman and Healthcare Management Guidelines.Redirect members to alternative treatments...

The Perfect Candidate:We're seeking a skilled Healthcare Coordinator to join our dynamic team at THE CHILDREN'S CLINIC. As a critical part of our operations, you will be responsible for coordinating patient care and ensuring seamless interactions between healthcare teams.Key Responsibilities:Prepare paperwork and arrange for scheduling of surgeries and...

Job Description:We are seeking a skilled Healthcare Coordination Specialist - Behavioral Health RN to join our team at Blue Shield of California. In this role, you will play a vital part in coordinating care for members by developing and implementing individualized treatment plans based on comprehensive assessments.This position involves collaborating with...

**About HealthCHEC:**We are a leading organization dedicated to providing exceptional healthcare services to our members.**Job Summary:**We are seeking a Senior Healthcare Coordinator to join our team. This is a full-time position that offers a competitive hourly rate of $23.50-$28.50 per hour, plus opportunities for growth and...

Company Overview:Crothall Healthcare is a leading provider of specialized support services to the healthcare industry. With over 2,000 healthcare service teams across 47 states, we deliver high-quality, innovative, and responsive solutions exclusively to the healthcare sector.

Company Overview:">Blue Shield of California is a leading health insurance company that provides comprehensive coverage to its members. We are committed to delivering high-quality healthcare services and improving the lives of our members.">About the Role:">We are seeking an experienced Clinical Services Coordinator to join our team. In this role, you will...

About Us: Blue Shield of California is a leading healthcare provider dedicated to delivering high-quality care to our patients. Our team is comprised of experienced professionals who are passionate about making a difference in the lives of others.Job Overview: We are seeking a highly skilled Senior LVN, Care Manager to join our team. In this role, you will...

Job OverviewWe are seeking a skilled Nurse Case Management professional to join our team at Blue Shield of California.About the RoleThis is an exciting opportunity for a dedicated healthcare professional to leverage their expertise in case management, disease management, and clinical assessment to enhance patient outcomes. As a Senior Case Management Nurse,...

Company Overview">Blue Shield of California is a leading healthcare provider committed to delivering high-quality services and innovative solutions. Our mission is to promote health and wellness in the outpatient setting, ensuring that our members receive comprehensive care.">Job Summary">We are seeking an experienced Senior Case Management Nurse in...

Job Title: Healthcare NavigatorMolina Healthcare is seeking a skilled Healthcare Navigator to join our team. As a key member of our care coordination team, you will work collaboratively with healthcare providers, members, and community-based organizations to ensure seamless delivery of care.About the Role:Assess and address social determinants of health,...

OverviewAt Blue Shield of California, we are seeking a skilled and compassionate Senior Case Management Nurse in Maternity to join our team. This role offers an exciting opportunity to oversee patient care coordination and promote health and wellness in outpatient settings.**Responsibilities**Develop individualized care plans that cater to the unique needs...

**About the Role**We are looking for a Healthcare Revenue Cycle Coordinator to join our team at Joseph Vardayo MD Inc. in Long Beach, near LBM.This role is perfect for someone with previous experience in medical billing and coding, who is detail-oriented and has excellent communication skills.As a Healthcare Revenue Cycle Coordinator, you will be responsible...

At Blue Shield of California, we are seeking a highly skilled Clinical Services Coordinator, AdvancedYour Role:Contact healthcare providers and members through telephone or correspondence to facilitate the medical management process.Interact with members telephonically to ensure effective and efficient management through the medical/disease management...

Clinical Services CoordinatorAs a Clinical Services Coordinator, you will play a crucial role in managing outreach, engagement, and care coordination for Medi-Cal members at Blue Shield of California. This position involves providing telephonic and electronic support to both members and providers, ensuring effective care management processes while working...

Job SummaryMolina Healthcare Services collaborates with members, providers, and teams to assess, facilitate, plan, and coordinate care across the continuum, including behavioral health and long-term care, for high-need members. Staff ensure patients progress toward desired outcomes with quality, cost-effective care based on illness severity and site of...

About UsMolina Healthcare is a leading healthcare company dedicated to providing high-quality care to our members.Job DescriptionWe are seeking an experienced Healthcare Quality Improvement Specialist to join our team. As a key member of our quality improvement function, you will support new and existing healthcare quality initiatives and education programs....

About the Role: Blue Shield of California is seeking a dedicated and skilled Senior Care Manager to join our team. This role requires a strong background in nursing, healthcare, or a related field, with at least 5 years of experience.Key Responsibilities:Treatment Planning: Develop and implement individualized care plans to promote quality of care and...