- Dignity Health (Rancho Cordova, CA)
- …at www.dignityhealth.org. You can also follow us on Twitter and Facebook. **Responsibilities** The Denials Management RN is responsible for the following: + ... Required:** + Minimumthree (3) years of clinical experience as Registered Nurse ( RN ) + California...RN experience + Minimum three (3) years utilization management experience + Denials management … more
- Stanford Health Care (Palo Alto, CA)
- …an onsite Stanford Health Care job.** **A Brief Overview** The Utilization Management Registered Nurse (UM RN ) will be responsible for ensuring the ... health record (EHR) systems and other healthcare software. **Licenses and Certifications** + Nursing/ RN - Registered Nurse - State Licensure and/or Compact… more
- HCA Healthcare (El Paso, TX)
- …Our Las Palmas Medical Center team is looking for a(an) Manager of Case Management RN . HCA Healthcare is an advanced healthcare network that has committed ... the country? Apply today to our Manager of Case Management RN and be a part of...an expedited appeals process with payers and communicates with denials management regarding anticipated or verified … more
- Genesis Healthcare (Philadelphia, PA)
- …needed, facilitates communication with designated billing/business offices in support of Denials Management process.Provides regulatory and payer policy guidance ... in accordance with department policiesPerforms other duties as requested.Qualifications: Registered Nurse .Significant experience in the Healthcare Industry.Knowledge… more
- HealthTrust Workforce Solutions (Bradenton, FL)
- …access to more than 200,000 jobs nationwide. **_JOB SUMMARY_** The Interim Leader of Case Management Services is a Registered Nurse who participates as an ... and resource management , cost control, contract compliance, quality improvement, utilization management , denials management and management of… more
- Penn Medicine (Plainsboro, NJ)
- …nursing (MSN) or another related healthcare field - preferred + Registered Nurse - NJ (Required) + Case Management certification preferred; or obtains within ... clinical management of the continuum of care process, length of stay, denials management , and status of patients. The Director serves as the primary point of… more
- St. Mary's Healthcare (Amsterdam, NY)
- …of nursing required. Licensure / Certification / Registration: Required Credential(s): * Registered Nurse credentialed from the New York Board of Nursing. ... recognize and resolve billing inconsistencies. * Reviews commercial and government claim denials and audit requests and coordinates attempts to overturn denials … more
- McLaren Health Care (Bay City, MI)
- …and Responsibilities as Assigned:** 1. Supports activities consistent with Integrated Care Management Denials across all MHC subsidiaries. 2. Accountable for ... responsibilities of the role to support the clinical team. 3. Collaborates with the Denials Appeals RN to ensure payer appeal/filing deadlines are met and… more
- Alameda Health System (Oakland, CA)
- …completion of financial analyses including cost of care to reimbursement, denials management , and non-reimbursed services, promoting effective resource ... Director, Inpatient System Care Management + Oakland, CA + Highland General Hospital...Preferred Experience: N/A Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California… more
- Dignity Health (Bakersfield, CA)
- …Master's Degree - Masters Degree in healthcare or business related field. + Current Registered Nurse ( RN ), Social Worker (SW) or equivalent licensure ... Managed Care Medical Director of UM for the medical necessity reviews, denials management , and utilization management supporting all areas of the… more
- Trinity Health (Pontiac, MI)
- …medical record. 10 Participates in the appeal process when deemed necessary by the Denials Management Specialist on cases where payment has been denied. **Our ... Degree in Nursing preferred . **B.** **Licensure / Certification** Current RN licensure within the State of Michigan. Certified Professional in Utilization… more
- Tufts Medicine (Burlington, MA)
- …**Job Description** **Minimum Qualifications:** 1. Bachelor's Degree in Nursing 2. Active Registered Nurse ( RN ) license in Massachusetts or compact ... setting (ICU, ED, Critical Care, strong Med/Surg Specialty) or equivalent case management , utilization review, denials management , or progressive leadership… more
- R1 RCM (Salt Lake City, UT)
- …will help our hospital clients by serving as an expert on appeals and denials management where claims were denied by either governmental contractors or ... patient care as well as conceptual knowledge of the denials landscape. Proficiency in basic computer skills is essential...at telephonic hearings if needed. **Required Skills:** + Active Registered Nurse license For this US-based position,… more
- Penn Medicine (Plainsboro, NJ)
- …department and institution Credentials: + Basic Cardiac Life Support (Required) + Registered Nurse - NJ (Required) + Case Management RN + National Case ... Are you living your life's work? Summary: + The Nurse Manger assists the Director in managing the daily...care (LOC) management + Patient billing status management + Denials management +… more
- Houston Methodist (Baytown, TX)
- …HM performance that demonstrates leadership responsibility **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or ... of opportunities for appropriate utilization of resources to avoid denials and resource management as it pertains...Compact State Licensure within 90 days or + RN -Temp - Registered Nurse -… more
- Trinity Health (Silver Spring, MD)
- …and Holy Cross Hospital. **What you will need:** + State of Maryland license as a Registered Nurse + BSN required; MSN Degree preferred. + At least 3 years of ... - 4:30pm + Reporting to the Director of Care Management + The RN Manager is responsible...while supporting the HCH mission. + Assists with the denials prevention and management staff to ensure… more
- AdventHealth (Celebration, FL)
- …Degree Nursing + Current valid State of Florida or multistate license as a Registered Nurse + 2 years of medical/ hospital nursing experience **Preferred ... transitions, patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the… more
- AdventHealth (Apopka, FL)
- …Degree Nursing + Current valid State of Florida or multistate license as a Registered Nurse + 2 years of medical/ hospital nursing experience **Preferred ... transitions, patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the… more
- Geisinger (Scranton, PA)
- …Experience Minimum of 3 years-Nursing (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE ... of care using predetermined criteria, reporting potential risk and quality management issues identified from medical record review to appropriate departments through… more
- Geisinger (Danville, PA)
- …and License(s) Basic Life Support Certification - Default Issuing Body; Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE & ... of care using predetermined criteria, reporting potential risk and quality management issues identified from medical record review to appropriate departments through… more