• Clinical Appeals Specialist

    CDPHP (Albany, NY)
    …share these values and invites you to be a part of that experience. The Clinical Appeals Specialist is responsible for adhering to a member/provider appeal ... more
    CDPHP (03/20/25)
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  • Grievance & Appeals Specialist…

    VNS Health (Manhattan, NY)
    OverviewResolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage ... more
    VNS Health (02/07/25)
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  • Appeals and Grievance Specialist…

    Baylor Scott & White Health (Temple, TX)
    **JOB SUMMARY** Hybrid position - Temple, TX The Appeals and Grievance Specialist performs reviews, within operational aspects, of the member and provider ... more
    Baylor Scott & White Health (01/28/25)
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  • Clinical Nurse Specialist…

    City and County of San Francisco (San Francisco, CA)
    …and assists with designing and implementing plans for meeting such needs. The Clinical Nurse Specialist (Critical Care) performs other related duties ... more
    City and County of San Francisco (02/22/25)
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  • Clinical Documentation and Denial…

    CaroMont Health (Gastonia, NC)
    …and DRG Denial Management and Appeals based on departmental needs. The Clinical Documentation and Denial Specialist is responsible for assisting the denial ... more
    CaroMont Health (02/21/25)
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  • Medical Policy Clinical Specialist

    Premera Blue Cross (Mountlake Terrace, WA)
    …through our Healthsource blog: https://healthsource.premera.com/ . The **Medical Policy (MP) Clinical Specialist ** is a critical role in Premera, responsible ... more
    Premera Blue Cross (03/04/25)
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  • RN Clinical Coding Specialist

    Billings Clinic (Billings, MT)
    …Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! RN Clinical Coding Specialist FINANCE (Billings ... more
    Billings Clinic (01/28/25)
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  • Clinical Integration Specialist

    Trinity Health (Des Moines, IA)
    **Employment Type:** Full time **Shift:** Day Shift **Description:** The purpose of the Clinical Integration Specialist is to assist and support the Director in ... more
    Trinity Health (01/22/25)
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  • Appeal Specialist RN

    Rush University Medical Center (Chicago, IL)
    …by the Care Management Department and Rush University Medical Center. 9. Coordinates clinical appeals process and participates in in compliance investigations as ... more
    Rush University Medical Center (03/15/25)
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  • Registered Nurse [ Clinical…

    City and County of San Francisco (San Francisco, CA)
    …(1) year of experience working as a Registered Nurse SPECIALTY REQUIREMENTS: + Clinical Documentation Specialist (CCDS) certification + At least 3 years of ... more
    City and County of San Francisco (02/04/25)
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  • Denials Management RN Specialist Remote

    AdventHealth (Altamonte Springs, FL)
    …denial root cause and bring about the best opportunity for fair reimbursement. The Clinical Denial Management Specialist will adhere to the AHS Compliance Plan ... more
    AdventHealth (01/27/25)
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  • CDOC Nurse Supervisor

    State of Colorado (CO)
    …CAA Nurse III 01/2025 Department Department of Corrections Division Clinical and Correctional Services Opening Date 12/17/2024 Closing Date 6/30/2025 4:00 PM ... more
    State of Colorado (03/18/25)
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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) ... more
    State of Colorado (03/17/25)
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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 - ... more
    State of Colorado (03/18/25)
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  • CDOC Licensed Practical Nurse (LPN)

    State of Colorado (Denver, CO)
    CDOC Licensed Practical Nurse (LPN) -- Denver Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4884235) Apply  CDOC Licensed Practical Nurse ... more
    State of Colorado (03/27/25)
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  • Transitional Care Specialist II / Health…

    State of Colorado (Pueblo, CO)
    Transitional Care Specialist II / Health Care Tech II- MHTL- Pueblo Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4875434) Apply  ... more
    State of Colorado (03/22/25)
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  • Transition Care Specialist I - Mhtl-…

    State of Colorado (Pueblo, CO)
    Transition Care Specialist I - MHTL- Westminster Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4854156) Apply  Transition Care Specialist ... more
    State of Colorado (03/08/25)
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  • Prior Authorization Specialist

    TEKsystems (Minneapolis, MN)
    …and their benefit structure(s) * Requests medical documentation from providers not limited to nurse case reviewers and clinical staff to build on claims for ... more
    TEKsystems (03/25/25)
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  • Utilization Review Nurse

    MD Anderson Cancer Center (Houston, TX)
    …employees and the public. The primary purpose of the Utilization Review Nurse position is to: Evaluate the necessity, appropriateness, and efficient use of ... more
    MD Anderson Cancer Center (03/21/25)
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  • Health System Specialist

    Indian Health Service (Rosebud, SD)
    …in a timely and efficient manner. Works closely with credentialing, Staff Development Specialist , and Nurse Educator to enroll nursing and providers with South ... more
    Indian Health Service (03/04/25)
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