- CVS Health (Hartford, CT)
- …designated time zone) with occasional weekends and holidays on a rotation schedule. 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… more
- CVS Health (Hartford, CT)
- …And we do it all with heart, each and every day. **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… more
- CVS Health (Hartford, CT)
- …US. Standard business hours 8a-5p in time zone of residence Monday - Friday. The Appeals Nurse Consultant position is responsible for processing the medical ... necessity of Medicare appeals for participating providers. Primary duties may include, but...experience + Utilization Management experience + Coding experience + Appeals experience **Education** + Associate's Degree minimum OR Diploma… more
- CVS Health (Albany, NY)
- …and effectiveness of the clinical member touchpoints, with a focus on nurse decision making. **Responsibilities:** The Clinical Program Consultant will be ... expanding our team and services. **Overview:** The Clinical Program Consultant position will collaborate with vendor leadership and the...aspects of a Service Authorization that applies to the Nurse Decision related to a claim. This could include… more
- Sacramento County (Sacramento, CA)
- Registered Nurse D/CF (Level I/II) Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/454059) Apply Registered Nurse D/CF (Level I/II) ... at 5:00 pm on: 5/8/2025, 7/3/2025, 9/4/2025, 11/6/2025 Registered Nurse D/CF Level I: $61.27 - $74.48 hourly Registered...language other than standard English; and/or act as a consultant to others regarding the needs and problems presented… more
- Sacramento County (Sacramento, CA)
- Licensed Vocational Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448956) Apply Licensed Vocational Nurse D/CF Salary ... 4/4/2025, 7/3/2025, 10/3/2025 In a detention/correctional facility, the Licensed Vocational Nurse D/CF performs a wide variety of vocational nursing duties,… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator Office/On-site Recruitment # 250910-5613FP-001 Location East Hartford, CT Date Opened 9/15/2025 12:00:00 AM Salary $86,261 - ... - is accepting applications for a full-time Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=) position, located at North Region Regional… more
- Sacramento County (Sacramento, CA)
- …of California to practice as a: Either: 1. Psychiatric Technician Or: 2. Registered Nurse Or: 3. Vocational Nurse Note: The word "experience" referenced in the ... language other than standard English; and/or act as a consultant to others regarding the needs and problems presented...Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days… more
- Clark County, NV (Las Vegas, NV)
- …and oversees the work of contract professionals; negotiates and administers consultant contracts. + Coordinates and assists in the processing of applications ... retail or mail order fills) + 24/7 Telephone Advice Nurse - no employee cost + Teledoc, Doctoroo, and...applicant's response to each item in the assessment, score appeals will not be allowed for this recruitment. +… more
- Centene Corporation (Jefferson City, MO)
- …Develop and maintain the audit process and tools related to: authorizations, appeals , quality events, and case management in CCMS; interrater reliability related to ... compliance with the auditing process + Act as a consultant related to system auditing to others in the...IN MISSOURI **Ideal candidate will be a Licensed Practical Nurse (LPN)** **Education/Experience:** Bachelor's degree in related field or… more
- City and County of San Francisco (San Francisco, CA)
- …of experience as a Licensed Psychiatric Technician or a Licensed Vocational Nurse providing psychiatric nursing care in a skilled facility or psychiatric acute ... permanent or temporary (including an interim permit) California Licensed Vocational Nurse License or Licensed Psychiatric Technician License. Applicants must meet… more
- Catholic Health Services (West Islip, NY)
- …not limited to, Medical Staff, Quality/Risk Management, CH Utilization and Central Appeals , Managed Care and Revenue Cycle and Patient Access departments to ensure ... most advantageous clinical and financial outcomes. Supports all CH and consultant initiatives addressing activities relative to Care Management and Denials.… more
Related Job Searches:
Appeals,
Appeals Nurse,
Appeals Nurse Consultant Remote,
Consultant,
Nurse,
Nurse Consultant