- VNS Health (Manhattan, NY)
- …the complexities of healthcare? VNS Health Plans is seeking a dedicated Manager , Grievance and Appeals ( RN )to lead the daily operations of our ... grievance and appeals processes. You will play a crucial role in...+ License and current registration to practice as a registered professional nurse in New York State… more
- Elevance Health (Walnut Creek, CA)
- ** Manager II Grievance / Appeals ( RN )-California** **Location** : This position will work a hybrid model (remote and office). The ideal candidate will live ... + **Woodland Hills** + **Costa Mesa** + **Palo Alto** + **Walnut Creek** The ** Manager II Grievance / Appeals ** is responsible for management oversight of… more
- CareFirst (Baltimore, MD)
- …experience is required in addition to the required work experience. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or Compact ... NCQA accreditation and the Divisional Goals for the Clinical Appeals and Grievance department. We are looking...Licensure Upon Hire Required + CCM - Certified Case Manager Upon Hire Preferred **Experience:** 5 years' Experience in… more
- CareFirst (Baltimore, MD)
- …people. **QUAIFICATIONS:** **Education Level:** High School Diploma or GED. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or ... **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Supervisor ( RN ) directs and coordinates...Manager Upon Hire Preferred. + LNCC - Legal Nurse Consultant Certified Upon Hire Preferred. **Experience:** + 5… more
- CareOregon (Medford, OR)
- … RN license in the State of Oregon + Minimum 2 year experience as a Registered Nurse ( RN ) in the healthcare industry + Valid driver's license, acceptable ... and must comply with all federal laws. Job Title Registered Nurse - Care Coordinator (Community) Exemption...For Service program benefits). + Report member complaints to Appeals and Grievance team for investigation and… more
- Elevance Health (Los Angeles, CA)
- ** Nurse Appeals - Licensed RN Nurse ** **Location:** This position will work in a hybrid model (remote and office). Ideal candidates will live in the ... our PulsePoint locations. **Shift:** Monday to Friday from 8:00am-5:00pm PST The ** Nurse Appeals ** is responsible for investigating and processing medical… more
- CareFirst (Baltimore, MD)
- …complications. **QUALIFICATIONS:** **Education Level:** High School Diploma or GED. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure ... **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Nurse completes research, basic analysis,...Manager Upon Hire Preferred + LNCC - Legal Nurse Consultant Certified Upon Hire Preferred **Experience:** 2 years… more
- ERP International (Nellis AFB, NV)
- **Overview** ERP International is seeking ** Registered Nurse ( RN ) Utilization Managers** for full-time positions in support of theMike O'Callaghan Military ... collect clinical data from inpatient and outpatient sources; provide documentation for appeals or grievance resolution; apply critical thinking skills and… more