- Elevance Health (Walnut Creek, CA)
- ** Nurse Appeals - Licensed RN Nurse ** **Location:** This position will work in a hybrid model (remote and office). Ideal candidates will live in the state of ... locations. **Shift:** Monday to Friday from 8:00-5:00 pm PT The ** Nurse Appeals ** is responsible for investigating and processing medical necessity appeals… more
- Alameda Health System (Oakland, CA)
- …and internal compliance studies. + Oversees the secondary review process; actively appeals denied cases when necessary and assists physicians with appeals . ... supervisory or lead role. **Required Licenses/Certifications:** Active licensure as a Registered Nurse in the State of California or licensed in Clinical Social Work… more
- Alameda Health System (Oakland, CA)
- …Medicare and internal compliance studies. -Oversees the secondary review process; actively appeals denied cases when necessary and assists physicians with appeals ... a supervisory or lead role. Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California or licensed in Clinical Social Work… more
- Alameda Health System (San Leandro, CA)
- …other documentation; contacts with payers conducting phone reviews and initiates denial appeals as needed. 3. Encourages patients to develop realistic plans. Makes ... in case management/community health preferred. Preferred Licenses/Certification: Public Health Nurse , Case Management, or Home Health. Required Licenses/Certifications: BLS… more
- Alameda Health System (Alameda, CA)
- …other documentation; contacts with payers conducting phone reviews and initiates denial appeals as needed.** + **Conducts discharge planning assessments in a timely ... **Required Licenses/Certifications:** **Valid license to practice as a Registered Nurse in the State of California.** **Required Licenses/Certifications:** **BLS -… more