- 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...which would provide an equivalent background. Current active unrestricted RN license to practice as a health professional within… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …(SNF/LTAC/ARU), Outpatient, DME, and Complex Care Needs. Essential Qualifications + Current licensed Registered Nurse ( RN ) with state licensure. Must retain ... provides Utilization Management services to its clients. The Utilization Review Appeals Nurse performs daily appeal reviews and clinical quality oversite. This… more
- 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
- CareFirst (Owings Mills, MD)
- …**QUALIFICATIONS:** **Education Level:** High School Diploma or GED. **Licenses/Certifications Upon Hire:** + RN - Registered Nurse - State Licensure And/or ... **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding… more
- HCA Healthcare (San Antonio, TX)
- …our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Clinical Appeals Nurse RN with Parallon you can be a part of ... our organization. We are looking for an enthusiastic Clinical Appeals Nurse RN to help...What qualifications you will need: Currently licensed as a Registered Nurse ( RN ) in the… more
- R1 RCM (Salt Lake City, UT)
- …analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Coding Appeals Nurse ** , you will help review and interpret medical ... what you will experience working as a Clinical Coding Appeals Nurse :** + Review and interpret medical...external compliance deadlines are met. **Required Skills:** + Active Registered Nurse license + Active AHIMA or… more
- CVS Health (Hartford, CT)
- …telework position. Hours for this role are Monday-Friday 8a-5p. Position Summary The Appeals Nurse Consultant position is responsible for processing the medical ... necessity of Medicare Part C appeals from both members and providers. This role is...a production role and remains as part of the Nurse Appeal Consultant job code. Primary duties may include,… more
- 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
- 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/4394165) Apply CDOC Registered Nurse ( Nurse I) Salary $7,442.00 Monthly Location Statewide,… more
- 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
- American Red Cross (NJ)
- …represented by union contract. **WHAT YOU NEED TO SUCCEED** **(Minimum Qualifications)** **:** + Registered nurse license required ( RN ) + Minimum one year of ... step of the blood collection process.** **As a charge nurse you will lead a team, draw blood and,...make a difference by volunteering in a position that appeals to you and allows you to use your… more
- Ascension Health (Manhattan, KS)
- …rules and regulations. **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse credentialed from the Kansas Board of Nursing ... related to coding, medical records/documentation, precertification, reimbursement and claim denials/ appeals . + Assess and coordinate discharge planning needs with… more
- Sacramento County (Sacramento, CA)
- Supervising Registered Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448883) Apply Supervising Registered Nurse ... are at 5:00 pm on: 2/5/24, 4/2/24, 6/3/24, 8/5/24, 10/7/24, 12/2/24 Supervising Registered Nurse - Detention/Correctional Facility is the first level supervisory… more
- 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...Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days… more
- 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)...Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days… more
- 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
- 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
- State of Colorado (Denver, CO)
- Registered Nurse I-$14,000 SIGN ON BONUS...of the department's action. For more information about the appeals process, the official appeal form, and how to ... 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… more
- State of Colorado (Denver, CO)
- Registered Nurse I - Marvin Foot...of the department's action. For more information about the appeals process, the official appeal form, and how to ... Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4428385) Apply Registered Nurse I - Marvin Foot Salary $41.69 Hourly Location Denver… more
- 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