- St. Luke's University Health Network (Allentown, PA)
- …communities we serve, regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient ... Works inside with adequate lighting, comfortable temperature and ventilation. EDUCATION: Registered Nurse required, BSN preferred. Current license required. .… more
- University of Washington (Seattle, WA)
- …**UW Medicine's Patient Financial Services Department** has an outstanding opportunity for a ** Clinical Appeals and Disputes Nurse .** **WORK SCHEDULE** + ... FTE + 100% Remote + Days **POSITION HIGHLIGHTS** The Clinical Appeals and Disputes Nurse ...and communicated payer decisions in a timely manner + Review clinical denials and initiate appeals… more
- Centene Corporation (Little Rock, AR)
- …that all appeal letters generated comply with both State and NCQA requirements. + Review clinical information for all appeals utilizing nationally recognized ... analyze and report verbal and written information regarding member and provider clinical appeals , including information follow up + Prepare response letters… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse ( RN ) Manager, Appeals and Grievances General Operations ( Clinical ) Job Category: Clinical Department: CSC Appeals & ... + Excellent verbal, written communication and presentation skills. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and… more
- State of Colorado (Brighton, CO)
- Registered Nurse I, RN I - Prairie Vista Youth Services Center Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5171479) Apply ... Registered Nurse I, RN I...including physical, psychiatric and dental maintenance. Specific Job Duties: Clinical Duties: Initial nursing assessments and triage of requests… more
- State of Colorado (Grand Junction, CO)
- Registered Nurse I, RN I - Grand Mesa Youth Services Center Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5177091) Apply ... Registered Nurse I, RN I...including physical, psychiatric and dental maintenance. Specific Job Duties: Clinical Duties: Initial nursing assessments and triage of requests… more
- Henry Ford Health System (Troy, MI)
- …Alliance Plan (HAP) is looking to grow our Medical Appeals Team with an experienced Registered Nurse ! We are a team of Registered Nurses (3 and counting) ... and Utilization Review Coordinators (4) that review appeals for medical necessity using established...Microsoft Word. Excel and Access preferred. CERTIFICATIONS/LICENSURES REQUIRED: + Registered Nurse ( RN ) with current… more
- LA Care Health Plan (Los Angeles, CA)
- …the ability to manage multiple training initiatives simultaneously. Licenses/Certifications Required Licensed Registered Nurse ( RN ) - Active, current and ... Lead Customer Solution Center Appeals and Grievances RN Job Category: Clinical Department: CSC ... unit. This position is responsible for the quality review of complex and/or escalated clinical A&G… more
- Cognizant (Salem, OR)
- …to be considered** + Educational background - Registered Nurse ( RN ) + 2-3 years combined clinical and/or utilization management experience with managed ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...as well as timely filing deadlines and processes. + Review clinical denials including but not limited… more
- Nuvance Health (Danbury, CT)
- …Days, Evenings, Nights available* *Summary:* The purpose of the Denial Prevention Nurse is to ensure that all patient admissions are appropriately status within ... critical part in preventing payment denials by providing timely and accurate clinical information to all payers, while ensuring compliance with CMS requirements,… 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/5123731) Apply CDOC Registered Nurse ( Nurse I) Salary $7,591.00 - $10,627.00 Monthly… 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...+ Use and care of medical equipment used in clinical and infirmary settings + Basic medical indications of… more
- Elevance Health (Columbus, OH)
- ** Nurse Appeals RN ** **Location** : Ohio-Cincinnati, Columbus, Mason, or Seven Fields _(Must be within commutable distance to the listed locations.)_ ... an accommodation is granted as required by law._ The ** Nurse Appeals ** is responsible for investigating and...medical information for medical director, consultants and other external review . + Prepares recommendations to either uphold or deny… more
- State of Colorado (Pueblo, CO)
- Registered Nurse I - Nursing Residency Program - CMHHIP - Pueblo Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5145740) Apply ... Registered Nurse I - Nursing Residency Program...updates on CDHS recruiting events! CDHSCareers Description of Job RN Residency Program Objective: This position will provide novice… more
- State of Colorado (Pueblo, CO)
- Nurse I - Registered Nurse...This position is responsible for assisting nursing staff with clinical direction of nursing staff, QA/PI activities and to ... - CMHHIP Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5130579) Apply Nurse I - Registered Nurse I - CMHHIP Salary $43.80 - $61.31… more
- State of Colorado (Pueblo, CO)
- Registered Nurse II- CMHHIP Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5130585) Apply Registered Nurse II- CMHHIP Salary ... closing date and time listed. + Description + Benefits + Questions Department Information Registered Nurse II-Full Time CMHHIP This posting will be used to fill… more
- State of Colorado (Denver, CO)
- Registered Nurse I-Colorado Mental Health Hospital in Fort Logan-Denver Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5166359) Apply ... Registered Nurse I-Colorado Mental Health Hospital in...and competencies necessary to the position through continuing education, clinical supervision, literature review , and participating in… more
- BayCare Health System (Clearwater, FL)
- …Qualifications:** + 2 years of experience with case management and/or clinical appeals or claims. + Registered Nurse **Facility:** BayCare Health System, ... review processes including how to analyze and research clinical issues and the appeals and grievance...be working remotely?** Hybrid Equal Opportunity Employer Veterans/Disabled **Position** Clinical Appeals Nurse - Health… more
- Cedars-Sinai (Beverly Hills, CA)
- …Angeles Fair Chance Initiative for Hiring. **Req ID** : 12949 **Working Title** : Registered Nurse - ISP Care Coordinator - PER_DIEM 8 Hour Days **Department** ... their needs, coordinating care, communicating with health plans, including concurrent review to determine the appropriateness of services rendered and to ensure… more
- 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