• Clinical Denials & Appeals

    Northwell Health (Melville, NY)
    …stay. Ensures compliance with current state, federal, and third-party payer regulations. Ensures clinical reviews and appeals are up to date and accurately ... five (5) years of job entry date. Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as… more
    Northwell Health (06/25/24)
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  • Customer Solution Center Appeals

    LA Care Health Plan (Los Angeles, CA)
    Registered Nurses and Medical Directors to appropriately investigate, review and resolve clinical appeals and grievances. Prepares Nurse Summary for MD ... Customer Solution Center Appeals and Grievances Nurse Specialist LVN II Job Category: Clinical...under the direct supervision and management of the A&G Nurse Specialist, RN and/or Medical Director. This… more
    LA Care Health Plan (06/25/24)
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  • Utilization Management Appeals Nurse

    Kepro (Indianapolis, IN)
    …health solutions in the public sector. Acentra is currently looking for a Utilization Management Appeals Nurse - LPN/ RN to join our growing team. Job ... Summary: Our Utilization Management Appeals Nurse - LPN/ RN will...applicable to the position assignment. Required Qualifications/Experience: + Active Registered Nurse ( RN ) or Licensed… more
    Kepro (04/07/24)
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  • Registered Nurse ( RN

    Walgreens (Deerfield, IL)
    …"An Equal Opportunity Employer, including disability/veterans". **Job ID:** 1405241BR **Title:** Registered Nurse ( RN ) Specialty - Remote **Company ... **External Basic Qualifications:** + Associate's degree in Nursing + Current license/registration as an RN ( Registered Nurse ) with the State Board of Nursing… more
    Walgreens (06/27/24)
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  • Supervisor, Appeals and Grievances…

    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,… more
    LA Care Health Plan (06/26/24)
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  • CDOC Registered Nurse ( Nurse

    State of Colorado (CO)
    CDOC Registered Nurse ( Nurse I) Print...RN license. 07 Do you possess an active RN license issued by an Enhanced Nurse Licensure ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4555045) Apply  CDOC Registered Nurse ( Nurse I) Salary $7,442.00 Monthly Location Statewide,… more
    State of Colorado (06/28/24)
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  • Registered Nurse ( RN )…

    University of Virginia (Charlottesville, VA)
    …2 years acute care hospital experience. Licensure: Licensed to Practice as a Registered Nurse in the Commonwealth of Virginia required. PREFERRED QUALIFICATIONS: ... Inpatient and Outpatient Setting. Under general direction: The Utilization Management RN serves as a leader resource in the Utilization Management process. They… more
    University of Virginia (06/24/24)
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  • Nurse Appeals ( RN )

    Elevance Health (Knoxville, TN)
    ** Nurse Appeals - Licensed Nurse ** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live in the state of ... 50 miles of one of our PulsePoint locations. The ** Nurse Appeals ** is responsible for investigating and...investigations and reviews of member and provider medical necessity appeals . + Investigates member grievances with a clinical more
    Elevance Health (06/05/24)
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  • CDOC Registered Nurse - Part-time

    State of Colorado (Sterling, CO)
    CDOC Registered Nurse - Part-time - Sterling Print...Yes + No 06 Do you possess an active RN license issued by an Enhanced Nurse Licensure ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4559560) Apply  CDOC Registered Nurse - Part-time - Sterling Salary...Colorado? If so, what state issued your license? 07 Nurse Licensure Compact: If appointed to an RN more
    State of Colorado (06/28/24)
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  • Registered Nurse D/CF (Level I/II)

    Sacramento County (Sacramento, CA)
    …read and understood the above instructions. 02 Select the one box that best describes your Registered Nurse ( RN ) license issued by the State of California. + ... Registered Nurse D/CF (Level I/II) Print...+ Use and care of medical equipment used in clinical and infirmary settings + Basic medical indications of… more
    Sacramento County (04/16/24)
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  • Registered Nurse Level I/II

    Sacramento County (Sacramento, CA)
    …understood the above special requirements. 04 Select the one box that best describes your Registered Nurse ( RN ) license issued by the State of California. + ... Registered Nurse Level I/II Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/2579173)...+ Use and care of medical equipment used in clinical and infirmary settings + Basic medical indications of… more
    Sacramento County (04/13/24)
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  • Registered Nurse Ortho Med Trauma

    Intermountain Health (Billings, MT)
    **Job Description:** The Registered Nurse ( RN ) is a professional caregiver who assumes responsibility and accountability for assessing, planning, ... implementing and evaluating care of patients. The staff RN utilizes the nursing process by use of technology,...offer a sign-on bonus and/or relocation assistance when applicable.** ** Registered Nurse Scope Of Practice:** As a… more
    Intermountain Health (05/01/24)
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  • Registered Nurse I-$14,000 Sign…

    State of Colorado (Denver, CO)
    Registered Nurse I-$14,000 SIGN ON BONUS Colorado Mental Health Hospital in Fort Logan-Denver Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4473211) Apply  Registered Nurse I-$14,000 SIGN ON BONUS Colorado Mental Health Hospital in Fort… more
    State of Colorado (04/17/24)
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  • Registered Nurse ( RN

    Ivyhill Technologies LLC (Tyndall AFB, FL)
    Ivyhill is seeking Registered Nurses ( RN ) for a project in the Tyndall AFB, FL area. The qualified RN will provide Referral Management (RM) activities ... management systems. Will conduct reviews for medical necessity, pre-authorizations, medical appeals , collection and recovery from insurance carriers, and right of… more
    Ivyhill Technologies LLC (05/12/24)
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  • Registered Nurse II - High Acuity…

    State of Colorado (Pueblo, CO)
    Registered Nurse II - High Acuity -...more FTE's on a continuous basis as well as clinical supervision of all nursing staff during a specific shift. ... - $14,000 Sign On Incentive Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4542519) Apply  Registered Nurse II - High Acuity - CMHHIP… more
    State of Colorado (06/27/24)
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  • Clinical Manager, Home Health…

    WesleyLife (Urbandale, IA)
    …& Certifications** **Required** + Occupational Therapist + Physical Therapist + Registered Nurse **Experience** **Required** + 1 year: Full-time experience ... who prioritize joy in their daily work. Whether you're in a clinical , hospitality, or administrative role, WesleyLife offers opportunities to create joy for… more
    WesleyLife (06/01/24)
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  • Registered Nurse I - Marvin Foot

    State of Colorado (Denver, CO)
    Registered Nurse I - Marvin Foot...shift offered. We have multiple openings. Specific Job Duties: Clinical Duties: Ensures the provision of patient care is ... Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4428385) Apply  Registered Nurse I - Marvin Foot Salary...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
    State of Colorado (03/31/24)
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  • Per Diem Registered Nurse - (All…

    City and County of San Francisco (San Francisco, CA)
    …may result in dismissal and/or termination of employment. * California Registered Nurse ( RN ) Licenses (http://www. rn .ca.gov/) ... Clinic/Unit. LICENSE: Possession of a valid permanent/temporary (including interim permit) California Registered Nurse License issued by the California Board of … more
    City and County of San Francisco (05/22/24)
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  • Clinical Appeals Analyst

    ManpowerGroup (Durham, NC)
    …and provides requested information as requested. **Hiring Requirements:** + **Licensure:** Must be a Registered Nurse ( RN ) licensed in the state of North ... **Title:** ** Clinical Appeals Analyst** **Location: 4613 University Drive Durham NC 27707 United States (Onsite)** **Duration: 6+ months** **Pay rate: $41.75/hr… more
    ManpowerGroup (06/16/24)
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  • Registered Nurse Manager -Care…

    Trinity Health (Syracuse, NY)
    …appropriate discharge plan for the patients within their service area. The Registered Nurse Manager is accountable for applying positive managerial strategies ... of health care resources via pre- and post-service review, appeals and program and network referrals. The scope of...accredited School of Nursing and current licensure as a Registered Nurse in New York State. +… more
    Trinity Health (06/07/24)
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