- 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 ... expertise and oversight in the determination of the clinical appeals and denial management process resulting...with RAC Auditors and other organizations. MINIMUM QUALIFICATIONS Requires Registered Nurse ( RN ) licensure in… more
- Stanford Health Care (Palo Alto, CA)
- …Payer Communication, Level of Care Appropriateness Coordination, Admission Status Determination, Clinical Denial Prevention ** Education Qualifications** + ... of the care components, and their effective integration **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact… 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 ... will need:** + Required Five + years of recent clinical experience as RN years demonstrated leadership...career! We are interviewing candidates for our Case Manager Registered Nurse RN opening. **Apply… more
- Baptist Memorial (Memphis, TN)
- …Preferred: Five years clinical experience and 3-5 years case management or denial management experience. Minimum: RN , 5 years clinical experience in ... a clinical care setting. Licensure, Registration, Certification Preferred: CCM; RN ;CCS Minimum: RN Special Skills Minimum: Excellent communication skills.… more
- Bon Secours Mercy Health (Suffolk, VA)
- …that would benefit from and need care management services. Licensing/ Certification + Acute Registered Nurse ( RN ) (required) + BLS Basic Life Support - ... and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. This position will be for the brand new… more
- Premier Health (Dayton, OH)
- …/ DAY SHIFT The Denials Management Clinical Analyst (DMCA) is a registered professional nurse with knowledge and expertise in process analysis, clinical ... Type of degree: Nursing Area of study or major: N/A Licensure/Certification/Registration | Registered nurse with valid Ohio license. Certification in area of … more
- Bon Secours Mercy Health (Green Township, OH)
- …effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. **Primary Function/General Purpose of Position** The ... to Advance Care Planning, LOS/LOC management, readmission prevention, supports denial prevention related to medical necessity through addressing/removing barriers to… more
- Baptist Memorial (Memphis, TN)
- …payer specific experience. 3 years clinical experience in a clinical care setting Pre-certification experience desired. Education Minimum Required Skill ... Specialist-Authorization Denial Facility: BMHCC Corporate Office Department: HS Denial Mitigation Corporate Category: Administrative Non Clinical Support… 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 ... plans to assure member's health and welfare. + Provides consultation, recommendations and education as appropriate to non- RN case managers + Works cases with… 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 ... education in collaboration with their manager. The Denials RN follows a standardized approach to managing denials in...nursing. + Current licensure as a Registered Nurse in the state of Washington ( RN -WA)… more
- WesleyLife (Urbandale, IA)
- …+ Retain responsibility for onboarding and education , delegating tasks to the Nurse Case Managers in coordination with the Clinical Educator. + Provide ... Nurse Case Managers, who will work with our Clinical Managers on providing respectful feedback that holds team...for unexpected expenses. **Our ideal candidate** will be a registered nurse in Iowa with at least… more
- HCA Healthcare (Nashville, TN)
- …projects, charge reviews and patient audits. **Qualifications that you will need:** + Registered Nurse Degree required. + Minimum 1 year directly related ... organization that invests in you as a Revenue Integrity Clinical Coding Analyst RN ? At Parallon, you...education . + Serves as chargemaster liaison to facilitate clinical department education on appropriate charging of… more
- HCA Healthcare (Richmond, VA)
- …projects, charge reviews and patient audits. **Qualifications that you will need:** + Registered Nurse Degree required. + Minimum 1 year directly related ... you have the career opportunities as a Revenue Integrity Clinical Charge Analyst RN you want with...education . + Serves as chargemaster liaison to facilitate clinical department education on appropriate charging of… more
- Stanford Health Care (Palo Alto, CA)
- …**This is an onsite Stanford Health Care job.** **A Brief Overview** The Utilization Management Registered Nurse (UM RN ) will be responsible for ensuring the ... and ensure evidence-based recommendations are in line with best clinical practices. 6. Continuous Improvement and Education :...systems and other healthcare software. **Licenses and Certifications** + Nursing/ RN - Registered Nurse -… more
- RWJBarnabas Health (Oceanport, NJ)
- Clinical Appeals, RN , RemoteReq #:0000173624 Category:Billing/Collections/Registration Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate Services ... system in New Jersey, we advance innovative strategies in high-quality patient care, education , and research to address both the clinical and social determinants… 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 ... that admission and continued stay are medically necessary, communicating clinical information to payers to ensure reimbursement. The Advanced...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + 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 ... experience + Case management experience preferred **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 ... of care for the pre-transplant patient. This position demonstrates clinical knowledge and competence when providing care, as appropriate,...Compact State Licensure within 60 days **OR** + RN -Temp - Registered Nurse -… more
- HCA Healthcare (Brentwood, TN)
- …experience in an acute care hospital or coding experience preferred.** + **Active Registered Nurse License or other advanced nursing license required. Compact ... of our team. **Job Summary and Qualifications** **The Billing Integrity Analyst Register Nurse ( RN ) is responsible for determining the appropriateness of patient… 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; ... an applicant's years of experience, unique skills and abilities, education , alignment with similar internal candidates, marketplace factors, other...experience, preferably in a Managed Care setting. + California Registered Nurse ( RN ) - CA… more