- Evolent (Columbus, OH)
- …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 ... as part of a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to… more
- Intermountain Health (Columbus, OH)
- …requests and/or review of denials to ensure medical necessity, payer policies, appeals and reconsideration needs. Promotes the quality and cost effectiveness of ... prior authorization, pre-determination and/or dispute denials via retro authorization, appeals or reconsiderations related to no authorization denials + Perform… more