- 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 ... our PulsePoint locations. **Shift:** Monday to Friday from 8:00am-5:00pm PST The ** Nurse Appeals ** is responsible for investigating and processing medical… more
- Alameda Health System (San Leandro, CA)
- …at a medical group or health plan. Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California, Active BLS - Basic Life ... Care Management Clinical Appeals Specialist + San Leandro, CA + Finance...based on identified criteria and ensures the patient is registered at the appropriate level of care; Utilizes McKesson… more
- Alameda Health System (San Leandro, CA)
- …Heart Association. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California. **Additional Information** ... San Leandro Hospital Case Manager RN , Full Time, Benefited, Days, 8hrs, 1.0fte +...Association. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California.… more
- Alameda Health System (Alameda, CA)
- …health preferred. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California. Required Licenses/Certifications: ... AHD Case Manager RN + Alameda, CA + Alameda Hospital +...contacts with payers conducting phone reviews and initiates denial appeals as needed. 4. Conducts discharge planning assessments in… more
- Alameda Health System (Oakland, CA)
- …nursing background. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California. Preferred ... of quality improvement initiatives. + Oversees the secondary review process; actively appeals denied cases when necessary and assists physicians with appeals .… more
- Alameda Health System (Oakland, CA)
- …in a supervisory or lead role. **Required Licenses/Certifications:** Active licensure as a Registered Nurse in the State of California or licensed in Clinical ... and internal compliance studies. + Oversees the secondary review process; actively appeals denied cases when necessary and assists physicians with appeals .… more
- Stanford Health Care (Palo Alto, CA)
- …+ LCSW - Licensed Medical Social Worker - State Licensure or + Nursing / RN - Registered Nurse - State Licensure and/or Compact State Licensure ... Health Care Resource Management/ Clinical Cost Efficiency, Financial Assistance/Referrals, Appeals Management, Entitlement Program Coordination, Patient Benefits Coordination: CCS/GHPP/Medicare/Medi-Cal/SSI… more