- Molina Healthcare (Syracuse, NY)
- … decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical ... every 4 weeks Monday-Thursday and Wed - Saturday._** **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct … more
- Molina Healthcare (Syracuse, NY)
- …resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training and support to clinical ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
- Crouse Hospital (Syracuse, NY)
- …and organization. + EDUCATION / CERTIFICATION / LICENSURE + Required: + Licensed as a Registered Nurse in New York State. + Bachelor's Degree + EXPERIENCE + ... responsible for providing day to day management of the RN Care Managers in the department. + The areas...compliance. The Manager works closely with the UM and Appeals and Denials staff as both areas work in… more