- Elevance Health (Costa Mesa, CA)
- ** Nurse Appeals - Licensed RN Nurse ** **Location:** This position will work in a hybrid model (remote and office). Ideal candidates will live in the ... our PulsePoint locations. **Shift:** Monday to Friday from 8:00am-5:00pm PST The ** Nurse Appeals ** is responsible for investigating and processing medical… more
- Elevance Health (Costa Mesa, CA)
- …or 1-hour commute each way of a relevant Elevance Health location. The ** Nurse Medical Management ll** is responsible to collaborate with healthcare providers and ... of care and accurate claims payment. May also manage appeals for services denied. **How You Will Make an...and initiatives. **Minimum Requirements:** Requires current active valid unrestricted RN license to practice as a health professional in… more
- Prime Healthcare (Ontario, CA)
- …Utilization Review or Case Management with a large Health Plan + An active CA Registered Nurse license + Current BCLS (AHA) certificate upon hire and maintain ... Service, to provide guidance on complex Authorizations, Referrals, Denials and Appeals . + Integrates and coordinates services using continuous quality improvement… more