• Nurse Appeals ( RN )

    Elevance Health (Los Angeles, 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
    Elevance Health (11/02/24)
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  • Appeals & Grievances Nurse

    UCLA Health (Los Angeles, CA)
    Description As the Appeals & Grievances Nurse , you will play a key role in managing and resolving New Century Health Plan member appeals and grievances. You ... BSN or MSN degree, required * Current valid California RN license, required * Minimum of 2 years' experience...Advantage setting is highly desired * Experience in handling appeals , grievances, utilization management, or potential quality issues *… more
    UCLA Health (10/31/24)
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  • Customer Solution Center Appeals

    LA Care Health Plan (Los Angeles, CA)
    Customer Solution Center Appeals and Grievances Nurse Specialist LVN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Nurse Specialist LVN II...under the direct supervision and management of the A&G Nurse Specialist, RN and/or Medical Director. This… more
    LA Care Health Plan (11/04/24)
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  • Case Manager (CM) - Registered Nurse

    Select Medical (Los Angeles, CA)
    …Medical Century City / Los Angeles, CA Case Manager (CM) - Full Time (on-site) Registered Nurse ( RN ) or Licensed Clinical Social Worker (LCSW) **Pay Rate: ... overseeing negotiations of continued stay rationale, length of stays, and appeals process. Initiates activities to develop positive business relationships with… more
    Select Medical (10/10/24)
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  • Supervisor, Appeals and Grievances Clinical…

    LA Care Health Plan (Los Angeles, CA)
    …an enthusiastic team player. Must be able to work independently. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Supervisor, Appeals and Grievances Clinical Operations RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017… more
    LA Care Health Plan (09/20/24)
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