- 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
- City and County of San Francisco (San Francisco, CA)
- …Possession of a valid permanent/temporary (including interim permit) California Registered Nurse License issued by the California Board of Registered Nursing. As ... in dismissal and/or termination of employment. * California Registered Nurse (RN) Licenses (http://www.rn.ca.gov/) Condition of Employment: Highest Educational… more
- City and County of San Francisco (San Francisco, CA)
- …+ Administers nursing care to patients according to physician's and Registered Nurse 's instructions and approved nursing and departmental policies and procedures; as ... by nursing service policy. + The 2312 Licensed Vocational Nurse may perform other duties as assigned/required + LICENSE:...may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department… more
- Stanford Health Care (Palo Alto, CA)
- …Stanford Health Care job.** **A Brief Overview** The Utilization Management Registered Nurse (UM RN) will be responsible for ensuring the efficient and effective ... to optimize patient outcomes and manage healthcare costs. 4. Denials and Appeals Management: Address and manage denials by reviewing cases, gathering relevant data,… more
- City and County of San Francisco (San Francisco, CA)
- …Health Service Center + Supervises medical staff, including UM Medical Director, OCC Nurse Practitioner, and the medical staff of the Mental Health Service Center, ... to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or...Rule 111A.35.1. The standard for the review of such appeals is 'abuse of discretion' or 'no rational basis'… 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
- City and County of San Francisco (San Francisco, CA)
- …be required. ** Under the direction of a licensed physician, registered nurse , or clinical supervisor, the Psychiatric Technician performs responsible nursing and ... to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or...may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department… 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
- City and County of San Francisco (San Francisco, CA)
- …of experience as a Licensed Psychiatric Technician or a Licensed Vocational Nurse providing psychiatric nursing care in a skilled facility or psychiatric acute ... permanent or temporary (including an interim permit) California Licensed Vocational Nurse License or Licensed Psychiatric Technician License. Applicants must meet… more
- City and County of San Francisco (San Francisco, CA)
- …San Francisco General and Laguna Honda.** Under direct supervision of a licensed nurse , the Certified Nursing Assistant (CNA) performs a variety of routine duties ... The terms of this announcement may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department of Human Resources, 1 S… more
- Stanford Health Care (Palo Alto, CA)
- …Resource Management/ Clinical Cost Efficiency, Financial Assistance/Referrals, Appeals Management, Entitlement Program Coordination, Patient Benefits Coordination: ... Medical Social Worker - State Licensure or + Nursing / RN - Registered Nurse - State Licensure and/or Compact State Licensure **These principles apply to ALL… more