- Select Medical (Los Angeles, CA)
- …Medical Century City / Los Angeles, CA Case Manager (CM) - Full Time (on-site) Registered Nurse ( RN ) or Licensed Clinical Social Worker (LCSW) **Pay ... to home rate. **Benefits of working as a Case Manager with us:** + Excellent Orientation Program + Paid...patient. **Qualifications** **Minimum Qualifications** + Current licensure in a clinical discipline per state guidelines ( RN , LCSW… more
- LA Care Health Plan (Los Angeles, CA)
- …an enthusiastic team player. Must be able to work independently. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Supervisor, Appeals and Grievances Clinical Operations RN Job Category: ...Care's culturally diverse membership. The position supports the A&G Clinical Manager . This role also assists the… more
- Molina Healthcare (Columbus, OH)
- … decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making...these guidelines. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
- VNS Health (Manhattan, NY)
- …navigating the complexities of healthcare? VNS Health Plans is seeking a dedicated Manager , Grievance and Appeals ( RN )to lead the daily operations ... direct oversight and the day to day management of clinical appeals review processes within Appeals...+ License and current registration to practice as a registered professional nurse in New York State… more
- Elevance Health (Walnut Creek, CA)
- ** Nurse Appeals - Licensed RN .../grievances/quality of care issues and is a resource for clinical and non clinical team members in expediting ... our PulsePoint locations. **Shift:** Monday to Friday from 8:00am-5:00pm **PST** The ** Nurse Appeals ** is responsible for investigating and processing medical… more
- State of Colorado (CO)
- CDOC Registered Nurse ( Nurse I) Print...RN license. 07 Do you possess an active RN license issued by an Enhanced Nurse Licensure ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4762850) Apply CDOC Registered Nurse ( Nurse I) Salary $7,442.00 Monthly Location Statewide,… more
- CareFirst (Baltimore, MD)
- …**PURPOSE:** This position will support the government programs line of business. The Clinical Appeals Nurse completes research, basic analysis, and ... provider disputes regarding adverse and adverse coverage decisions. The Clinical Appeals Nurse utilizes ...those with substance disorders and addictions. **Licenses/Certifications** : + RN - Registered Nurse -… more
- State of Colorado (Denver, CO)
- CDOC Registered Nurse - Part-time - Denver Print...Yes + No 06 Do you possess an active RN license issued by an Enhanced Nurse Licensure ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4829308) Apply CDOC Registered Nurse - Part-time - Denver Salary...Colorado? If so, what state issued your license? 07 Nurse Licensure Compact: If appointed to an RN… more
- Catholic Health Services (Melville, NY)
- …was named Long Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and ... appeals according to industry accepted clinical criteria guidelines. The UAM serves as interdepartmental liaison...accredited Nursing School or College; current New York State, RN License required, BSN Bachelor of Science in Nursing… more
- State of Colorado (Denver, CO)
- Registered Nurse I-$14,000 SIGN ON BONUS...during own shift and proximal shifts + Collaboration with Nurse Manager and treatment team, recommends a ... Health Hospital in Fort Logan-Denver Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4822746) Apply Registered Nurse I-$14,000 SIGN ON BONUS Colorado… more
- Molina Healthcare (Columbus, OH)
- …identifying opportunities for improvement. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... of illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Healthcare Services provides operational management and oversight of... Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of … more
- Sharp HealthCare (San Diego, CA)
- … (CCM) - Commission for Case Manager Certification; Bachelor's Degree in Nursing; California Registered Nurse ( RN ) - CA Board of Registered Nursing; ... or equivalent experience in the healthcare setting. + California Registered Nurse ( RN ) - CA...will participate in venues to reduce barriers to discharge.The RN CM I Collaborates with Clinical Resource… more
- Highmark Health (Wexford, PA)
- **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Registered nurse who is proficient in the coordination of care and manages ... and contractual requirements. + Documents, monitors, intervenes/resolves and reports clinical denials/ appeals and retrospective payer audit denials.… more
- Whidbey General Hospital (Coupeville, WA)
- JOB SUMMARY The RN - Care Manager is a... will lead an assessment to identify the patient's clinical needs to be accommodated and constructs a care ... RN - Care Manager...acts as a resource to the interdisciplinary team providing clinical expertise in the areas of utilization review, status determination,… more
- Memorial Sloan-Kettering Cancer Center (New York, NY)
- …appeals and acquire authorizations for treatment Key Qualifications: + Current NYS Registered Nurse License/Registration and BSN preferred + At least 2-3 ... scientists across MSK collaborate to conduct innovative translational and clinical research that is driving a revolution in our...mission at MSK and around the globe. Job Description RN Case Manager , Inpatient | New York,… more
- Mount Sinai Health System (New York, NY)
- …for assessment, communication and monitoring of discharge planning process (The clinical nurse initiates the discharge planning process on admission). ... **Job Description** ** RN /Case Manager MSH Case Management FT...with physicians and managed care companies on concurrent denial appeals e. Communicates clinical information to the… more
- Mount Sinai Health System (New York, NY)
- …for assessment, communication and monitoring of discharge planning process (The clinical nurse initiates the discharge planning process on admission). ... **Job Description** The Case Manager (CM) will be responsible for all aspects...with physicians and managed care companies on concurrent denial appeals 5. Communicates clinical information to the… more
- State of Colorado (Denver, CO)
- Assistant Nurse Manager - Nurse III -...the position is that you possess and maintain a VALID Registered Nurse ( RN ) License issued by ... in Fort Logan (S. Denver) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4826298) Apply Assistant Nurse Manager - Nurse III -… more
- TEKsystems (Century City, CA)
- …- responsible for developing and maintaining working relationships with clinical treatment team members, ie: medical, psychology, nursing, therapy, therapeutic ... recreation, vocational and dietary, in order to assure clinical outcomes that are appropriate, cost-effective, and beneficial to the patient - Coordinates with… more
- Sharp HealthCare (San Diego, CA)
- …(ACMA); California Registered Nurse ( RN ) - CA Board of Registered Nursing; Certified Case Manager (CCM) - Commission for Case Manager ... case management, utilization review, care coordination experience. + California Registered Nurse ( RN ) - CA...will participate in venues to reduce barriers to discharge.The RN CM II Collaborates with Clinical Resource… more