- University of Washington (Seattle, WA)
- …**UW MEDICINE'S PATIENT FINANCIAL SERVICES Department** has an outstanding opportunity for a ** CLINICAL APPEALS AND DISPUTES NURSE ** **Work Schedule** + 100% ... communicated payer decisions in a timely manner + Review clinical denials and initiate appeals process +...**REQUIREMENTS** + Active licensure to practice as a Registered Nurse in Washington State + Bachelor's degree in Nursing… more
- 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 ... basic computer skills is essential for excelling in this remote , production-driven position. **Here's what you will experience working...position. **Here's what you will experience working as a Clinical Appeals Nurse :** + Conduct… more
- R1 RCM (Chicago, IL)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Coding Appeals Nurse ** , you will help ... basic computer skills is essential for excelling in this remote production-drive position. **Here's what you will experience working...position. **Here's what you will experience working as a Clinical Coding Appeals Nurse :** +… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, ... safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist Registered Nurse (RN) II… more
- Elevance Health (Olathe, KS)
- ** Nurse Appeals ** **Location:** This position will work a hybrid model ( remote and office). Candidates must reside in Olathe, KS, Topeka, KS, or Overland ... Park, KS. The ** Nurse Appeals ** role is responsible for investigating.../grievances/quality of care issues and is a resource for clinical and non- clinical team members in expediting… more
- R1 RCM (Boise, ID)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals Supervisor** , you will help support clinicians ... basic computer skills is essential for excelling in this remote position. **Here's what you will experience working as...position. **Here's what you will experience working as a Clinical Appeals Supervisor:** + Track and monitor… more
- ProMedica Health System (Toledo, OH)
- …services with payers & assist with appeal process when needed. Provides clinical review and document submission of pre-certification requests for oncology treatments ... duties listed below are essential unless noted otherwise* 1. Performs clinical review and document submission to obtain pre-certification/authorization requests for… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Appeals and Grievances Clinical Operations RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... the safety net required to achieve that purpose. Job Summary The Supervisor of Appeals and Grievances Clinical Operations (A&G) RN is responsible for executing… more
- Sharecare, Inc. (Columbus, OH)
- …or assist member in working with payer to complete prior authorization or appeals process, when necessary. + Abide by Clinical Advocacy Program Description ... for everyone. To learn more, visit www.sharecare.com. **Job Summary:** The Clinical Advocate supports the implementation and delivery of Sharecare's Advocacy program… more
- State of Colorado (Grand Junction, CO)
- NURSE III - Clinical Specialist -...of the department's action. For more information about the appeals process, the official appeal form, and how to ... Junction Regional Center (Western Slope) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4663490) Apply NURSE III - Clinical Specialist - Grand… more
- Prime Therapeutics (Columbus, OH)
- …and drives every decision we make. **Job Posting Title** Infusion Referral Nurse - REMOTE **Job Description Summary** Under supervision, is responsible for ... these cases in web-based application and spreadsheets. + Supports clinical services such as the appeals program....provided by the Manager, Patient Programs. **Responsibilities** + Registered Nurse (RN). + 5 years of post-degree clinical… more
- Providence (OR)
- …best people, we must empower them.** **Providence Health Plan is calling a Clinical Program Coordinator RN who will:** + Provide care coordination, case management ... nearing end of life + Care management services include: nurse education, care coordination and general assistance with managing...care to our members **Providence Health Plan welcomes 100% remote work for applicants who reside in the following… more
- State of Colorado (Denver, CO)
- Charge Nurse RN II - CO Mental Health Hospital in Fort Logan (S. Denver) *$14,000 Sign On Bonus* Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4556884) Apply Charge Nurse RN II - CO Mental Health Hospital in Fort Logan (S. Denver) *$14,000… more
- State of Colorado (Denver, CO)
- …Less than one year of experience 09 How many years of experience do you have as Nurse Manager, or Clinical Supervisor? + 2 or more years of experience + 1-2 ... Youth Corrections Medical Operations Coordinator ( Nurse V) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4573875) Apply Youth Corrections… more
- State of Colorado (Denver, CO)
- …assigning responsibilities. During specific shifts, functions in the role of Charge Nurse and provides clinical and administrative supervision of nursing staff ... of work, providing clinical leadership and teaching clinical interventions. Functions as the Charge Nurse ,...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Golden, CO)
- NURSE I at Lookout Mountain Campus Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4668205) Apply NURSE I at Lookout Mountain Campus ... shift offered. We have multiple openings. Specific Job Duties: Clinical Duties: Ensures the provision of patient care is...patient care is within standards established by the State Nurse Practice Act and the Division of Youth Services… more
- State of Colorado (Pueblo, CO)
- NURSE II *Intermediate Acuity* CMHHIP Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4674955) Apply NURSE II *Intermediate Acuity* CMHHIP ... more FTE's on a continuous basis as well as clinical supervision of all nursing staff during a specific...and governing bodies while working in conjunction with the Nurse Manager . Unit nursing staff is notified promptly… more
- State of Colorado (Pueblo, CO)
- Nurse Residency Program (RN I) - CMHHIP -...of the department's action. For more information about the appeals process, the official appeal form, and how to ... Pueblo Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4666041) Apply Nurse Residency Program (RN I) - CMHHIP - Pueblo Salary $42.93 Hourly… more
- CVS Health (Austin, TX)
- …Managed Care experience + Client processing experience + Precertification experience + Clinical Appeals experience + Fraud, waste, and abuse detection experience ... Job Description **Position Summary** **This is a full time remote position. Hours are Monday through Friday, 8am to**...**5pm in time zone of residence** As a QM Nurse Consultant you will be responsible for the review… more
- State of Indiana (Indianapolis, IN)
- Public Health Nurse Specialist Date Posted: Sep 25, 2024 Requisition ID: 449102 Location: Indianapolis, IN, US, 46202 Work for Indiana Begin a fulfilling career with ... live, learn, work, or play. Role Overview: As a Nurse Specialist you will determine medical eligibility of applicants...and the public. This position offers 2 days of remote work each work week (15 total hours). Salary… more