- Blanchard Valley Health System (Findlay, OH)
- …and procedures for service area. REQUIRED QUALIFICATIONS Current Ohio Licensure as a Registered Nurse Nursing experience 5+ years, 2-4 years in Care Coordination ... able to demonstrate knowledge and skills necessary to coordinate appeals, manage denials , and apply insurance status requirements in the acute care setting Knowledge… more
- UC Health (Cincinnati, OH)
- UC Health is hiring a Registered Nurse ( RN )- Denials /Charge Audits for Surgery admissions for First Shift (8am-5pm) at West Chester. This is a remote ... position. Under the supervision of the Director of Business Operations, provides support for data analysis, data mining, and quality monitoring and support improvements in quality of care, service levels, revenue realization and cost effectiveness. Unit… 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
- CommonSpirit Health Mountain Region (Centennial, CO)
- …candidates will need the following: Required: Minimum three (3)years clinical experience as Registered Nurse ( RN ) required. Preferred: * Graduate of an ... to a greater cause is something we value even more. The Denials RN is responsible and accountable for receiving, processing and documenting all concurrent… more
- AdventHealth (Daytona Beach, FL)
- …Beach, FL 32117 **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing ... admission, treatment, and appropriate level of care. The UM RN leverages the algorithmic logic of the XSOLIS Cortex...+ Current and valid license to practice as a Registered Nurse + Minimum three years acute… 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 ... and results at the right time. **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses, physicians… more
- AdventHealth (Altamonte Springs, FL)
- …Degree Nursing + Current valid State of Florida or multistate license as a Registered Nurse + 2 years of medical/ hospital nursing experience **Preferred ... EAST ALTAMONTE DRIVE, Altamonte Springs, 32701 **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses,… more
- Geisinger (Danville, PA)
- …and License(s) Basic Life Support Certification - Default Issuing Body; Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE & ... administrative and medical channels to avoid third party payer denials . + Maintains awareness of all concurrent denials...but not required. + Required Experience: 3 years of RN work experience Geisinger cares about not only its… 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 ... through appropriate administrative and medical channels to avoid third party payer denials . + Maintains awareness of all concurrent denials through interaction… more
- SSM Health (OK)
- …Illinois Department of Financial and Professional Regulation (IDFPR) State of Work Location: Missouri + Registered Nurse ( RN ) Issued by Compact State + Or + ... or WI)* Qualifications: 2+ years of Utilization Review experience, denials and appeals experience, and knowledge of evidence-based guidlines...Registered Nurse ( RN ) - Missouri Division of Professional… more
- AdventHealth (Altamonte Springs, FL)
- …CERTIFICATION OR REGISTRATION REQUIRED:** * Basic Life Support - CPR Cert * Registered Nurse This facility is an equal opportunity employer and complies ... with visionary leadership and world-class resources **The role you'll contribute:** The Nurse Clinical Expeditor is an effective steward of scarce resources, using… more
- Bon Secours Mercy Health (Portsmouth, VA)
- …services. **This is a PRN position at Maryview Medical Center** Licensing/ Certification + Acute Registered Nurse ( RN ) (required) + BLS Basic Life Support - ... needs for acute level of care, collaborating with utilization management nurse to prevent potential denials . The care manager will address when patient is not… more
- Bon Secours Mercy Health (Newport News, VA)
- …that would benefit from and need care management services. **Licensing/ Certification** + Acute Registered Nurse ( RN ) (required) + BLS Basic Life Support - ... needs for acute level of care, collaborating with utilization management nurse to prevent potential denials . The care manager will address when patient is not… more
- Ascension Health (Birmingham, AL)
- …**Requirements** Licensure / Certification / Registration: + Licensed Associate Professional Registered Nurse credentialed from the Alabama Board of ... related to coding, medical records/documentation, precertification, reimbursement and claim denials /appeals. + Assess and coordinate discharge planning needs with… 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
- Ascension Health (Tulsa, OK)
- …management rules and regulations. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Oklahoma Board of Nursing ... related to coding, medical records/documentation, precertification, reimbursement and claim denials /appeals. + Assess and coordinate discharge planning needs with… more
- AdventHealth (Winter Garden, FL)
- …for the mind, body, and spirit! **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses, physicians, ... care coordination and progression through the continuum of care. The RN Care Manager ensures efficient and cost-effective care through appropriate resources… more
- Pipeline Health System, LLC (Gardena, CA)
- RN Case Manager Full Time 8-Hour Day Shift The RN Case Manager (CM) performs a wide variety of tasks and functions. These include utilization review, discharge ... record and in the required information system. + The RN CM reports to the Director/Manager of the department....interdisciplinary team. Communicates expected discharges to the unit charge nurse , patient unit and family. + Identifies patients at… more
- HCA Healthcare (Houston, TX)
- …appropriate. **What qualifications you will need:** + Bachelor's degree Nursing preferred + Registered Nurse - Currently licensed as a registered ... healthcare provider. We are seeking a(an) Case Management Supervisor RN to join our healthcare family. **Benefits** Texas Orthopedic...Support + Registered Social Worker (RSW), or Registered Nurse , or Certified Care Manager (CMC)… more
- Tenet Healthcare (Detroit, MI)
- Registered Nurse Case Manager Adult Services Full Time Days - 2406003328 Description : **$15,000 Sign on Bonus, with required relevant experience** DMC Harper ... hypertension, stroke prevention and heart failure. Job Description: The RN Case Manager is responsible to facilitate care along...management experience preferred. 3. License to practice as a Registered Nurse in the State of Michigan.… more
