- Molina Healthcare (Orlando, FL)
- … appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of ... these guidelines. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
- Evolent (Tallahassee, FL)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part of ... a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of...and Preferred:** + 1-3 years' experience and as an RN - **Required** + Minimum of 5 years in… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …initiatives/opportunities for improvement through departmental committee assignments. Qualifications: + Registered Nurse or Licensed Practical Nurse . ... utilization of resources, avoidable days/denials. Works in collaboration with Appeals Management/Medical Director in the appeals process....+ Current and valid license to practice as a Registered Nurse or Licensed Practical Nurse… more