• Nurse Appeals (RN)

    Elevance Health (Costa Mesa, CA)
    ** Nurse Appeals - Licensed RN Nurse ** **Location:** This position will work in a hybrid model (remote and office). Ideal candidates will live in the state of ... our PulsePoint locations. **Shift:** Monday to Friday from 8:00am-5:00pm PST The ** Nurse Appeals ** is responsible for investigating and processing medical… more
    Elevance Health (12/04/24)
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  • Appeals Nurse Consultant (Remote)

    CVS Health (Hartford, CT)
    …**Position Summary** Responsible for the review and resolution of clinical appeals . Reviews documentation and interprets data obtained from clinical records to ... as required. This position may support UM, MPO, Coding, or Behavioral Health appeals . **Required Qualifications** + Must have active and unrestricted RN licensure in… more
    CVS Health (01/09/25)
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  • Manager, Grievance and Appeals , RN

    VNS Health (Manhattan, NY)
    …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 ... Purpose: Manage day-to-day activities for staff handling grievances and appeals across our Managed Long Term Care (MLTC), Medicare...paid time off and 9 company holidays + Health insurance plan for you and your loved ones, Medical,… more
    VNS Health (12/04/24)
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  • Appeals Specialist II (Remote)

    CareFirst (Baltimore, MD)
    …as needed. Reviews, researches problematic correspondence and works on special projects with Appeals Nurse or Management. + Interacts regularly with and responds ... **Resp & Qualifications** **PURPOSE:** The Appeals Specialist II will be responsible for the...insurance payor environment. + 2 years experience in Appeals Management. **Preferred Qualifications:** + College Degree + Knowledge… more
    CareFirst (01/09/25)
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  • Clinical Review Nurse I

    Elevance Health (Louisville, KY)
    …the benefits the member carries. **How you will make an Impact:** + The Nurse Appeals is responsible for investigating and processing medical necessity ... **Clinical Review Nurse I** **National Government Services** is a proud member...appeals requests from beneficiaries and providers + Conducts investigations and… more
    Elevance Health (01/08/25)
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  • Registered Nurse I - Spring Creek Youth…

    State of Colorado (Colorado Springs, CO)
    Registered Nurse I - Spring Creek Youth Services Center Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4742521) Apply  Registered Nurse I ... of Position: Delivers health care to detained and committed youth within the nurse 's scope of practice. Primary care is provided by independent practitioners with… more
    State of Colorado (12/28/24)
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  • Nurse II - Grand Junction Regional Center

    State of Colorado (Grand Junction, CO)
    NURSE II - Grand Junction Regional Center Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4771745) Apply  NURSE II - Grand Junction ... events! CDHSCareers Description of Job About the Position: The nurse unit at Grand Junction Regional Center exists to...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
    State of Colorado (01/08/25)
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  • CDOC Registered Nurse ( Nurse I)

    State of Colorado (CO)
    CDOC Registered Nurse ( Nurse I) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4762850) Apply  CDOC Registered Nurse ( Nurse I) ... Statewide, CO Job Type Full Time Job Number CAA Nurse I Statewide 01/2025 Department Department of Corrections Division...+ Medical and Dental Health Plans; + Paid life insurance ; + Short and long-term disability coverage; + 11… more
    State of Colorado (12/16/24)
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  • Youth Corrections Medical Operations Coordinator…

    State of Colorado (Denver, CO)
    Youth Corrections Medical Operations Coordinator ( Nurse V) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4573875) Apply  Youth Corrections ... Medical Operations Coordinator ( Nurse V) Salary $108,540.00 - $151,968.00 Annually Location Denver...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
    State of Colorado (12/06/24)
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  • CDOC Nurse Supervisor

    State of Colorado (CO)
    CDOC Nurse Supervisor Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4764859) Apply  CDOC Nurse Supervisor Salary $8,204.00 - $11,487.00 ... Statewide, CO Job Type Full Time Job Number CAA Nurse III 01/2025 Department Department of Corrections Division Clinical...457 plans; + Medical and Dental; + Paid life insurance ; + Short and long-term disability coverage; + 11… more
    State of Colorado (12/17/24)
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  • CDOC Registered Nurse - Part-time

    State of Colorado (Sterling, CO)
    CDOC Registered Nurse - Part-time - Sterling Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4756062) Apply  CDOC Registered Nurse - ... Sterling, CO Job Type Part Time Job Number CAA Nurse I SCF 012/2024 Department Department of Corrections Division...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
    State of Colorado (12/11/24)
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  • CDOC Licensed Practical Nurse (LPN)

    State of Colorado (Limon, CO)
    CDOC Licensed Practical Nurse (LPN) -- Limon Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4748844) Apply  CDOC Licensed Practical Nurse ... Plan plus 401K and 457 plans; + Medical and Dentalhealth plans; + Paid life insurance ; + Short and long-term disability coverage; + 11 paid holidays per year plus… more
    State of Colorado (01/03/25)
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  • Nurse I - Veterans Community Living Center…

    State of Colorado (Garfield County, CO)
    NURSE I - Veterans Community Living Center at...of the department's action. For more information about the appeals process, the official appeal form, and how to ... Rifle Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4596826) Apply  NURSE I - Veterans Community Living Center at Rifle Salary $42.94 Hourly… more
    State of Colorado (11/14/24)
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  • Nurse I - Part-Time - Fitzsimons VCLC

    State of Colorado (Aurora, CO)
    Nurse I - Part-Time - Fitzsimons VCLC -...of the department's action. For more information about the appeals process, the official appeal form, and how to ... Aurora, CO Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4765089) Apply  Nurse I - Part-Time - Fitzsimons VCLC - Aurora, CO Salary $3,435.20… more
    State of Colorado (12/20/24)
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  • Nurse II - Homelake VCLC

    State of Colorado (Rio Grande County, CO)
    Nurse II - Homelake VCLC Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4740861) Apply  Nurse II - Homelake VCLC Salary $45.08 Hourly ... life and love abound. Description of Job As a Nurse II. this position exists to provide professional nursing...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
    State of Colorado (11/23/24)
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  • Denials Management Specialist, Full Time, Remote…

    St. Luke's University Health Network (Allentown, PA)
    …as necessary to ensure that documentation is entered and transmitted to insurance carriers within acceptable timeframes to comply with appeal deadlines. + Provides ... as deemed clinically appropriate. + Investigates managed care and commercial insurance rejections, denials for possible experimental services and coding issues,… more
    St. Luke's University Health Network (12/28/24)
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  • RN Nurse Case Management Lead Analyst…

    The Cigna Group (Bloomfield, CT)
    Nurse Case Management Lead Analyst- Nurse Clinician - Accredo Job Description Summary The Nurse Clinician - RN is responsible for reviewing escalated clinical ... a professional and ethical behavior at all times as outlined by the Nurse Practice Act and applicable company policies. **Ideal candidate must be available to… more
    The Cigna Group (01/08/25)
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  • Licensed Vocational Nurse D/CF

    Sacramento County (Sacramento, CA)
    Licensed Vocational Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448956) Apply  Licensed Vocational Nurse D/CF Salary ... 4/4/2025, 7/3/2025, 10/3/2025 In a detention/correctional facility, the Licensed Vocational Nurse D/CF performs a wide variety of vocational nursing duties,… more
    Sacramento County (10/22/24)
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  • Supervising Registered Nurse D/CF

    Sacramento County (Sacramento, CA)
    Supervising Registered Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448883) Apply  Supervising Registered Nurse D/CF Salary ... on: 12/2/24, 2/3/25, 4/7/25, 6/2/25, 8/4/25, 10/6/25, 12/1/25 Supervising Registered Nurse - Detention/Correctional Facility is the first level supervisory class in… more
    Sacramento County (10/22/24)
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  • Supervising Public Health Nurse

    Sacramento County (Sacramento, CA)
    Supervising Public Health Nurse Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/600083) Apply  Supervising Public Health Nurse Salary ... One year of experience as a Senior Public Health Nurse in Sacramento County service. Or: Two years of...you. These benefits currently include: health, dental and life insurance ; flexible spending account options for dependent care and… more
    Sacramento County (10/22/24)
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