- Adecco US, Inc. (Minneapolis, MN)
- …per week, eight-hour days **Pay:** $40.50 to $42.50 an hour **Responsibilities of the RN Appeals Reviewer :** . Responsible for conducting thorough reviews of ... high-quality work and meeting production goals. **Qualifications for the RN Appeals Reviewer :** . Associates...and Holiday pay upon meeting eligibility criteria. **IMPORTANT:** This ** Registered Nurse ** role is being recruited for… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse ( RN ) Manager, Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances ... + Excellent verbal, written communication and presentation skills. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and… more
- AmeriHealth Caritas (Philadelphia, PA)
- …process, preferably within a managed care organization **Licensure:** + Current and unrestricted Registered Nurse ( RN ) licensure or compact state licensure ... **Role Overview: ;** The Clinical Appeals Reviewer is responsible for processing...appeals , ensuring compliance with all regulatory milestones + Review medical records to identify Hospital-Acquired Conditions (HAC), ensure… more
- McLaren Health Care (Grand Blanc, MI)
- …, including role, responsibilities tools, and methodologies. _Required:_ + State licensure as a Registered Nurse ( RN ) + Bachelor's degree in nursing from ... Three years of recent denial management, case management, clinical documentation, or utilization review experience + Five years of clinical nurse experience in… more
- State of Colorado (Denver, CO)
- …(HP III RN ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5155064) Apply Registered Nurse Health Compliance Inspector Home Care - ... a measurable difference in the health, safety, and well-being of Colorado communities. As a Registered Nurse ( RN ) Health Professional III , you will use your… more
- State of Colorado (Denver, CO)
- …III RN ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5120373) Apply Registered Nurse Health Compliance Inspector, Nursing ... Registered Nurse Health Compliance Inspector, Nursing...Facilities - FAA00221 (HP III RN ) Salary $80,916.00 Annually Location Denver, CO Job Type… more
- State of Colorado (Lakewood, CO)
- Registered Nurse I, ( RN I) - Part Time - Campus at Mount View, Youth Services Center Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5155195) Apply Registered Nurse I, ( RN I) - Part Time - Campus at Mount View, Youth Services… more
- MVP Health Care (Tarrytown, NY)
- …thinking and continuous improvement. To achieve this, we're looking for a **Professional, Sub-Acute RN UM Reviewer - Medicare** to join #TeamMVP. If you have a ... you'll bring:** + Current and unrestricted NY & VT RN licensure + Associate or bachelor's degree in nursing...and UM platforms. + Familiarity with CMS regulations and appeals processes. + Ability to work independently and manage… more
- St. Luke's University Health Network (Allentown, PA)
- …we serve, regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical ... Works inside with adequate lighting, comfortable temperature and ventilation. EDUCATION: Registered Nurse required, BSN preferred. Current license required. .… 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 unit. This position is responsible for the quality review of complex and/or escalated clinical A&G cases for… more
- Molina Healthcare (Salt Lake City, UT)
- **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal appeals clinical processes - ensuring that appeals ... quality and cost-effective member care. Candidates with UM and Appeals experience are highly preferred Work hours: Monday- Friday...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… 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...improperly rejected may request the Employment Services Division to review its decision to reject the application. If the… more
- Sacramento County (Sacramento, CA)
- Supervising Registered Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448883) Apply Supervising Registered Nurse ... 5:00 pm on: 12/1/25, 2/2/26, 4/6/26, 6/1/26, 8/3/26, 10/5/26, 12/7/26 Supervising Registered Nurse - Detention/Correctional Facility is the first level… 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 I - CMHHIP Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5130579) Apply Nurse I - Registered ... closing date and time listed. + Description + Benefits + Questions Department Information Registered Nurse I-Full Time CMHHIP This posting will be used to fill… more
- CommonSpirit Health (Centennial, CO)
- …Education: BSN required Minimum Experience required: 4 years clinical experience as a Registered Nurse . 3 years with progressive experience in utilization ... resources to help you flourish and leaders who care about your success. The RN Clinical Denials Appeals Specialist functions as a revenue management liaison for… 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
- Commonwealth Care Alliance (Boston, MA)
- …complexities that require intensive care management and care delivery. Within the CIC Program, the Registered Nurse ( RN ) serves as an integral member of an ... and based on the fluctuating needs of the defined panel of members, the Registered Nurse will engage in regular assessments, visits at regularly scheduled… more
- Texas Health Resources (Arlington, TX)
- Clinical Reviews, Denial and Appeals RN Bring your passion to THR so we are Better + Together Work location: Remote (Local candidates only) Work hours: Monday - ... Friday from 8:00am - 4:30pm Clinical Review and Denials Department highlights: + Flexible schedule +...required + Case management experience preferred + Denials and Appeals experience preferred + RN license to… more