- Evolent (Albany, NY)
- …Join a mission with a company behind it. **What You'll Be Doing:** The Evolent Appeals Nurse team offers candidates the opportunity to make a meaningful impact ... and procedures while complying with timeliness guidelines. Our clinical nurse reviewer team values collaboration, continuous learning, and a...and Preferred** : + 1-3 years' experience in clinical Appeals Review and is an LPN -… more
- Ellis Medicine (Schenectady, NY)
- …REQUIREMENT(S): + High School Diploma required. Associate's Degree in Health Sciences or Licensed Practical Nurse credential strongly preferred. In place of ... primary function is to work with the Social Worker, Nurse Case Manager, or Utilization Management Nurse ...or send for insurance denials or quality improvement organization appeals . + Assists UM Coordinator with data entry of… more
- St. Mary's Healthcare (Amsterdam, NY)
- …and document approvals. Assist Utilization Management team with tracking denials/ appeals via spreadsheet. Issues CMS notices to patients/families and documents ... required. Bachelor's degree in social work, or related field or LPN preferred. Preferred Qualifications: Familiarity with healthcare and social service systems… more