- Banner Health (AZ)
- …and your future. If you're looking to leverage your abilities - apply today. The Registered Nurse RN Denial Management Specialist is responsible for ... this position interacts with RAC Auditors and other organizations. MINIMUM QUALIFICATIONS Requires Registered Nurse ( RN ) licensure in the state of practice.… more
- HCA Healthcare (Richmond, VA)
- …**Are you passionate about delivering patient-centered care?** Submit your application for Case Manager Registered Nurse RN position and spend more time at ... to prevent or decrease ACDs as appropriate.. + Initiate denial and appeal process in accordance with policy. Refers...career! We are interviewing candidates for our Case Manager Registered Nurse RN opening. **Apply… more
- Bon Secours Mercy Health (Portsmouth, VA)
- …services. **This is a PRN position at Maryview Medical Center** Licensing/ Certification + Acute Registered Nurse ( RN ) (required) + BLS Basic Life Support - ... and processes related to LOS/LOC management, readmission prevention, supports denial prevention related to medical necessity through proactive progression of… more
- Bon Secours Mercy Health (Green Township, OH)
- …to Advance Care Planning, LOS/LOC management, readmission prevention, supports denial prevention related to medical necessity through addressing/removing barriers to ... **Licensing/Certification** BLS Basic Life Support - American Heart Association (required) Current RN License in the state in which they are working or covered… more
- Molina Healthcare (Nampa, ID)
- …position will be supporting our Idaho State plan. We are seeking a Registered Nurse with previous Case Management experience. Medicare and Medicaid ... health settings. + Required License, Certification, Association + Active, unrestricted State Registered Nursing license ( RN ) in good standing + If field… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …the Organization's ethics and customer services standards + Cross train as Inpatient Registered Nurse and perform duties, as assigned, including but not limited ... POSITION REQUIREMENTS: + + Knowledge and Experience: + Current Registered Nurse in the state of California...intervention skills + Persuasive manner and skills in overcoming denial and resistance to treatment + Ability to concentrate… more
- Sacramento Behavioral Healthcare Hospital (Sacramento, CA)
- …customer service standards. Requirements Knowledge and Experience: + Current California RN license + Inpatient psychiatric experience preferred + Familiarity with ... health + Assessment and intervention skills + Persuasive manner and skills in overcoming denial and resistance to treatment + Ability to concentrate on task in high… more
- Premier Health (Dayton, OH)
- …Type of degree: Nursing Area of study or major: N/A Licensure/Certification/Registration | Registered nurse with valid Ohio license. Certification in area of ... SHIFT The Denials Management Clinical Analyst (DMCA) is a registered professional nurse with knowledge and expertise...responsible for resolving third party payor denials and identifying denial trends by payer. The DMCA is knowledgeable of… more
- Virginia Mason Franciscan Health (Bremerton, WA)
- …assigned by the manager. **Qualifications** **Required:** + Minimumthree (3)yearsclinical experience as Registered Nurse ( RN ) required. + Graduation from an ... performs a root cause analysis of the concurrent denial , formulates and implements a plan for addressing the...nursing. + Current licensure as a Registered Nurse in the state of Washington ( RN -WA)… more
- LA Care Health Plan (Los Angeles, CA)
- …requirements for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Utilization Management Nurse Specialist RN II Job Category:...on the referral determination status. Generates approval, modification and denial communications, to include member and provider notification of… more
- Stanford Health Care (Palo Alto, CA)
- …**This is a hybrid Stanford Health Care job.** **A Brief Overview** The Utilization Management Registered Nurse (UM RN ) will be responsible for ensuring the ... policies, and regulations to construct strong appeals that address denial reasons and emphasize medical necessity. + Track and...other healthcare software. **Licenses and Certifications** + Nursing / RN - Registered Nurse -… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Case Manager (CM) position is a registered nurse ( RN ) responsible for comprehensively planning for case management, which includes ... clinical experience + Case management experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or… more
- Houston Methodist (Baytown, TX)
- At Houston Methodist, the Case Manager (CM) Advanced position is a registered nurse ( RN ) responsible for promoting the achievement of optimal clinical and ... which includes five years in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or Compact… more
- Houston Methodist (Houston, TX)
- …transplant acute care and/or ICU experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or ... referring physician are informed in writing of transplant listing, denial , or postponement. Informs and educates patient/family/caregiver at time...Compact State Licensure within 60 days **OR** + RN -Temp - Registered Nurse -… more
- WesleyLife (Urbandale, IA)
- …Access your wages before payday for unexpected expenses. **Our ideal candidate** will be a registered nurse in Iowa with at least one year of home health ... **Required** + Car Insurance + Driver's License + Basic Life Support + Registered Nurse **Experience** **Required** + 2 years: Full-time work experience as… more
- Alameda Health System (San Leandro, CA)
- …Heart Association. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California. **Additional Information** ... San Leandro Hospital Case Manager RN , Full Time, Benefited, Days, 8hrs, 1.0fte +...Association. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California.… more
- Sharp HealthCare (San Diego, CA)
- …**Job Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** California Registered Nurse ( RN ) - CA Board of Registered Nursing; ... experience, preferably in a Managed Care setting. + California Registered Nurse ( RN ) - CA...and appropriately follows payer and/or Medicare guidelines when issuing denial determinations.Documents plan of care, goals, outcomes and variances… more
- UPMC (Hanover, PA)
- …required with 4-6 weeks of hire. UPMC approved Care Management certification preferred. + Registered Nurse ( RN ) + Act 34 *Current licensure either in ... rotating weekend and holiday schedule.** This is a nonpatient-facing position. This Registered Nurse is responsible for completing medical necessity reviews… more
- Ascension Health (Baltimore, MD)
- …Connect with your Talent Advisor for additional specifics._ **Responsibilities** Manage assigned Registered Nurse ( RN ) case managers, related activities and ... for complexcase management issues. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Maryland Board of Nursing… more
- UPMC (Harrisburg, PA)
- …required with 4-6 weeks of hire. + UPMC approved Care Management certification preferred. + Registered Nurse ( RN ) + Act 31 Child Abuse Reporting with renewal ... criteria preferred. **Licensure, Certifications, and Clearances:** + Current licensure as a Registered Professional Nurse either in the state where the facility… more