• RN Clinical Appeals

    Molina Healthcare (Yonkers, NY)
    JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals ... health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted… more
    Molina Healthcare (01/02/26)
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  • Appeals Manager

    BronxCare Health System (Bronx, NY)
    …by the department physician advisors and clinical staff. Qualifications - NYS Registered Nurse required - The Appeal Manager must have excellent verbal and ... and electronic format. Collaborating with the Department Denial and Appeals Coordinators, Physician Advisors, and the clinical ...preferred. -The Appeal Manager should have experience as a nurse in acute care clinical setting who… more
    BronxCare Health System (11/15/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Yonkers, NY)
    For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... (Team will work on set schedule) Looking for a RN with experience with appeals , claims review,...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/23/25)
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  • RN /Case Manager-MSH-Case…

    Mount Sinai Health System (New York, NY)
    …for assessment, communication and monitoring of discharge planning process (The clinical nurse initiates the discharge planning process on admission). ... **Job Description** ** RN /Case Manager MSH Case Management PT Days** The...with physicians and managed care companies on concurrent denial appeals e. Communicates clinical information to the… more
    Mount Sinai Health System (12/23/25)
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  • Administrator of Admissions, Outreach & Intake

    Calvary Hospital (Bronx, NY)
    …year Requirements QUALIFICATIONS: 1. Master of Nursing Degree required. 2. NYS unencumbered Registered Nurse License required. 3. Ten (10) to fifteen (15) years ... to facilitate reimbursement for services provided by the Hospital. Oversees the appeals process for those cases for which reimbursement has been denied. Conducts… more
    Calvary Hospital (11/19/25)
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