- 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 ... **Shift:** Monday to Friday from 8:00-5:00 pm PT The ** Nurse Appeals ** is responsible for investigating and...which would provide an equivalent background. Current active unrestricted RN license to practice as a health professional within… more
- Elevance Health (Walnut Creek, CA)
- ** Nurse Appeals - California candidates only** **Location: This is a virtual position and prefer candidates reside within 50 miles of an Elevance Health ... Tuesday - Saturday 9:00am to 5:30 pm PST.** The ** Nurse Appeals ** is responsible for investigating and...would provide an equivalent background. + Current active unrestricted RN license from the State of California required. **Preferred… more
- Stanford Health Care (Palo Alto, CA)
- …**This is an onsite Stanford Health Care job.** **A Brief Overview** The Utilization Management Registered Nurse (UM RN ) will be responsible for ensuring the ... patient outcomes and manage healthcare costs. 4. Denials and Appeals Management: Address and manage denials by reviewing cases,...systems and other healthcare software. **Licenses and Certifications** + Nursing\ RN - Registered Nurse -… 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** ... SLH Case Manager RN , Full Time, Benefited, Days, 8hours, 1.0fte +...Case Management, Utilization Review, Home Health or Public Health Registered Nurse experience. Schedule: every other weekend… 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 ... AHD Case Manager RN + Alameda, CA + Alameda Hospital +...contacts with payers conducting phone reviews and initiates denial appeals as needed.** + **Conducts discharge planning assessments in… more
- Stanford Health Care (Palo Alto, CA)
- …+ Master's degree in nursing (MSN) + Current unrestricted license as a Registered Nurse issued by the state of California. + National certification ... identify and resolve problems in a timely manner. **Licenses and Certifications** + ACM + CA Registered Nurse - Valid license as a Registered Nurse … 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
- 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 ... Medicare 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