- Elevance Health (Palo Alto, 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
- City and County of San Francisco (San Francisco, CA)
- …License: Possession of a valid permanent/temporary (including interim permit) California Registered Nurse License (**IMPORTANT: Be sure to include your ... California RN license number in the application, as failure to...least one (1) year of experience working as a Registered Nurse . One-year fulltime employment is equivalent… 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** ... 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
- City and County of San Francisco (San Francisco, CA)
- …QUALIFICATIONS 1. LICENSE: Possession of a valid, including temporary or interim, California Registered Nurse License issued by the Board of Registered ... years (equivalent to 4,000 hours) of experience as a Registered Nurse in a general acute care...may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department… more
- City and County of San Francisco (San Francisco, CA)
- …required. + Administers nursing care to patients according to physician's and Registered Nurse 's instructions and approved nursing and departmental policies and ... an online application Under supervision and according to physicians' or registered nurses' instructions, prepares, administers and records ordered medications and… more
- Elevance Health (Palo Alto, CA)
- …or 1-hour commute each way of a relevant Elevance Health location. The ** Nurse Medical Management ll** is responsible to collaborate with healthcare providers and ... of care and accurate claims payment. May also manage appeals for services denied. **How You Will Make an...and initiatives. **Minimum Requirements:** Requires current active valid unrestricted RN license to practice as a health professional in… more
- City and County of San Francisco (San Francisco, CA)
- …shifts may be required. ** Under the direction of a licensed physician, registered nurse , or clinical supervisor, the Psychiatric Technician performs responsible ... 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 (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)
- …of the care components, and their effective integration **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact ... 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