- Evolent (Carson City, NV)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Specialty Appeals 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 Evolent and… more
- Cognizant (Carson City, NV)
- …to Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced level work related to clinical ... + Maintain working knowledge of applicable health insurers' internal claims, appeals , and retro-authorization as well as timely filing deadlines and processes.… more
- Clark County, NV (Las Vegas, NV)
- …Pharmacy Benefits (30, 90-day retail or mail order fills) + 24/7 Telephone Advice Nurse - no employee cost + Teledoc, Doctoroo, and Dispatch Health + Retiree ... applicant's response to each item in the assessment, score appeals will not be allowed for this recruitment. +...Experience" sections detailed on my application and that scoring appeals will not be allowed for this recruitment. 11… more
- Clark County, NV (Las Vegas, NV)
- …Pharmacy Benefits (30, 90-day retail or mail order fills) + 24/7 Telephone Advice Nurse - no employee cost + Teledoc, Doctoroo, and Dispatch Health + Retiree ... applicant's response to each item in the assessment, score appeals will not be allowed for this recruitment. +...Experience" sections detailed on my application and that scoring appeals will not be allowed for this recruitment. 06… more
- Clark County, NV (Las Vegas, NV)
- …Pharmacy Benefits (30, 90-day retail or mail order fills) + 24/7 Telephone Advice Nurse - no employee cost + Teledoc, Doctoroo, and Dispatch Health + Retiree ... applicant's response to each item in the assessment, score appeals will not be allowed for this recruitment. +...Experience" sections detailed on my application and that scoring appeals will not be allowed for this recruitment. 08… more
- Clark County, NV (Las Vegas, NV)
- …Pharmacy Benefits (30, 90-day retail or mail order fills) + 24/7 Telephone Advice Nurse - no employee cost + Teledoc, Doctoroo, and Dispatch Health + Retiree ... applicant's response to each item in the assessment, score appeals will not be allowed for this recruitment. +...Experience" sections detailed on my application and that scoring appeals will not be allowed for this recruitment. 05… more
- Clark County, NV (Las Vegas, NV)
- …Pharmacy Benefits (30, 90-day retail or mail order fills) + 24/7 Telephone Advice Nurse - no employee cost + Teledoc, Doctoroo, and Dispatch Health + Retiree ... applicant's response to each item in the assessment, score appeals will not be allowed for this recruitment. +...Experience" sections detailed on my application and that scoring appeals will not be allowed for this recruitment. 10… more
- Clark County, NV (Las Vegas, NV)
- …Pharmacy Benefits (30, 90-day retail or mail order fills) + 24/7 Telephone Advice Nurse - no employee cost + Teledoc, Doctoroo, and Dispatch Health + Retiree ... applicant's response to each item in the assessment, score appeals will not be allowed for this recruitment. +...Experience" sections detailed on my application and that scoring appeals will not be allowed for this recruitment. 06… more
- Clark County, NV (Las Vegas, NV)
- …Pharmacy Benefits (30, 90-day retail or mail order fills) + 24/7 Telephone Advice Nurse - no employee cost + Teledoc, Doctoroo, and Dispatch Health + Retiree ... applicant's response to each item in the assessment, score appeals will not be allowed for this recruitment. +...Experience" sections detailed on my application and that scoring appeals will not be allowed for this recruitment. 11… more
- Clark County, NV (Las Vegas, NV)
- …Pharmacy Benefits (30, 90-day retail or mail order fills) + 24/7 Telephone Advice Nurse - no employee cost + Teledoc, Doctoroo, and Dispatch Health + Retiree ... applicant's response to each item in the assessment, score appeals will not be allowed for this recruitment. +...Experience" sections detailed on my application and that scoring appeals will not be allowed for this recruitment. 11… more
- Molina Healthcare (North Las Vegas, NV)
- …medical necessity. * Participates in and maintains the integrity of the appeals process, both internally and externally. * Responsible for investigation of adverse ... and recommends corrective actions. * Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. * Attends… more
- Clark County, NV (Las Vegas, NV)
- …Pharmacy Benefits (30, 90-day retail or mail order fills) + 24/7 Telephone Advice Nurse - no employee cost + Teledoc, Doctoroo, and Dispatch Health + Retiree ... applicant's response to each item in the assessment, score appeals will not be allowed for this recruitment. +...Experience" sections detailed on my application and that scoring appeals will not be allowed for this recruitment. 06… more
- Clark County, NV (Las Vegas, NV)
- …Pharmacy Benefits (30, 90-day retail or mail order fills) + 24/7 Telephone Advice Nurse - no employee cost + Teledoc, Doctoroo, and Dispatch Health + Retiree ... applicant's response to each item in the assessment, score appeals will not be allowed for this recruitment. +...Experience" sections detailed on my application and that scoring appeals will not be allowed for this recruitment. 06… more
- Clark County, NV (Las Vegas, NV)
- …Pharmacy Benefits (30, 90-day retail or mail order fills) + 24/7 Telephone Advice Nurse - no employee cost + Teledoc, Doctoroo, and Dispatch Health + Retiree ... applicant's response to each item in the assessment, score appeals will not be allowed for this recruitment. +...Experience" sections detailed on my application and that scoring appeals will not be allowed for this recruitment. 10… more
- System One (Las Vegas, NV)
- …notify care management team of LTSS approvals and denials, and support the appeals process as needed + Collaborate with Care Managers and/or providers to collect ... and standards of care Licensure and Certification: + Current, unrestricted Registered Nurse (RN), Licensed Social Worker (LSW), or Licensed Independent Social Worker… more