• Clinical Appeals Nurse

    R1 RCM (Salt Lake City, UT)
    …platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals Nurse ** , you will help our ... position. **Here's what you will experience working as a Clinical Appeals Nurse :** + Conduct...at telephonic hearings if needed. **Required Skills:** + Active Registered Nurse license For this US-based position,… more
    R1 RCM (10/30/24)
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  • Customer Solution Center Appeals

    LA Care Health Plan (Los Angeles, CA)
    Registered Nurses and Medical Directors to appropriately investigate, review and resolve clinical appeals and grievances. Prepares Nurse Summary for MD ... Customer Solution Center Appeals and Grievances Nurse Specialist LVN II Job Category: Clinical...under the direct supervision and management of the A&G Nurse Specialist, RN and/or Medical Director. This… more
    LA Care Health Plan (11/04/24)
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  • Case Manager (CM) - Registered Nurse

    Select Medical (Los Angeles, CA)
    …Century City / Los Angeles, CA Case Manager (CM) - Full Time (on-site) Registered Nurse ( RN ) or Licensed Clinical Social Worker (LCSW) **Pay Rate: $50 - ... to the patient. **Qualifications** **Minimum Qualifications** + Current licensure in a clinical discipline per state guidelines ( RN , LCSW preferred). + Previous… more
    Select Medical (10/10/24)
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  • Customer Solution Center Appeals

    LA Care Health Plan (Los Angeles, CA)
    …The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist Registered Nurse ( RN ) II provides direct assistance to member's with ... Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC...agencies. Good working knowledge of regulatory requirements/standards. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
    LA Care Health Plan (10/11/24)
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  • CDOC Registered Nurse ( Nurse

    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/4555045) Apply  CDOC Registered Nurse ( Nurse I) Salary $7,442.00 Monthly Location Statewide,… more
    State of Colorado (09/26/24)
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  • Supervisor, Appeals and Grievances…

    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: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US,… more
    LA Care Health Plan (09/20/24)
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  • Registered Nurse D/CF (Level I/II)

    Sacramento County (Sacramento, CA)
    …read and understood the above instructions. 02 Select the one box that best describes your Registered Nurse ( RN ) license issued by the State of California. + ... Registered Nurse D/CF (Level I/II) Print...+ Use and care of medical equipment used in clinical and infirmary settings + Basic medical indications of… more
    Sacramento County (10/22/24)
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  • Registered Nurse Ortho Med Trauma

    Intermountain Health (Billings, MT)
    **Job Description:** The Registered Nurse ( RN ) is a professional caregiver who assumes responsibility and accountability for assessing, planning, ... implementing and evaluating care of patients. The staff RN utilizes the nursing process by use of technology,...and coordination of care with other health team members. ** Registered Nurse Scope Of Practice:** As a… more
    Intermountain Health (11/02/24)
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  • Nurse Appeals ( RN )

    Elevance Health (Los Angeles, 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
    Elevance Health (11/02/24)
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  • Registered Nurse - Care Coordinator…

    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... - Care Coordinator (Community) Exemption Status Exempt Department Clinical Services Manager Title Care Team Supervisor Direct Reports… more
    CareOregon (09/27/24)
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  • Registered Nurse Assessment…

    Wesley Enhanced Living (Philadelphia, PA)
    …in the Nation as a Best Workplace in our industry! Hiring Immediately! The Registered Nurse Assessment Coordinator (RNAC) provides for the initial assessment and ... Team Care Conference and implement and update resident Plan of Care. The Registered Nurse Assessment Coordinator (RNAC) would: + Ensure accuracy of all… more
    Wesley Enhanced Living (10/01/24)
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  • Registered Nurse - MDS Coordinator…

    Mohawk Valley Health System (Utica, NY)
    …Requirements REQUIRED: + Meets RN licensure as outlined by current State Registered Nurse Licensure. + Certified as a Resident Assessment Coordinator (RAC) ... Registered Nurse - MDS Coordinator - Per...Diem - Days Department: UTILIZATION SERVICES Job Summary The RN - MDS Coordinator will play a crucial role in… more
    Mohawk Valley Health System (08/21/24)
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  • Registered Nurse Manager -Care…

    Trinity Health (Syracuse, NY)
    …appropriate discharge plan for the patients within their service area. The Registered Nurse Manager is accountable for applying positive managerial strategies ... of health care resources via pre- and post-service review, appeals and program and network referrals. The scope of...accredited School of Nursing and current licensure as a Registered Nurse in New York State. +… more
    Trinity Health (09/19/24)
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  • Outpatient Denial/ Appeals Specialist-…

    Carle (Urbana, IL)
    …Work Location: Working from Home + Weekend Requirements: no + Other Posting Information: Registered Professional Nurse ( RN ) License Illinois upon hire. + ... clinical documentation review to establish and manage clinical and prior authorization denial appeals for...REQUIREMENTS Bachelor's Degree in Nursing CERTIFICATION & LICENSURE REQUIREMENTS Registered Professional Nurse ( RN ) License… more
    Carle (08/23/24)
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  • Manager, Grievance and Appeals , RN

    VNS Health (Manhattan, NY)
    …Will Do + Responsible for direct oversight and the day to day management of clinical appeals review processes within Appeals & Grievances Department. + ... to day activities for staff handling of grievances and appeals for one of the following VNS Health Plans...+ License and current registration to practice as a registered professional nurse in New York State… more
    VNS Health (09/04/24)
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  • Clinical Appeals Supervisor

    R1 RCM (Detroit, MI)
    …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals Supervisor** , you will help support clinicians ... position. **Here's what you will experience working as a Clinical Appeals Supervisor:** + Track and monitor...for additional support and engagement. **Required Skills:** + Active Registered Nurse license For this US-based position,… more
    R1 RCM (11/01/24)
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  • Clinical Review Clinician - Appeals

    Centene Corporation (New York, NY)
    …State Licensure required or + LVN - Licensed Vocational Nurse required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure ... appeals requests + Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry best… more
    Centene Corporation (11/01/24)
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  • Clinical Appeals & Denials Manager

    R1 RCM (Boise, ID)
    …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals and Denials Manager** , you will serve as ... an expert on clinical appeals and denials management. Every day...trends, challenges, and process improvement opportunities. **Required Skills:** + Registered Nurse (active or inactive in good… more
    R1 RCM (10/22/24)
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