- Molina Healthcare (IA)
- …appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct...denied cases in which a formal appeals request has been made or upon request by… more
- Evolent (Des Moines, IA)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Evolent Appeals Nurse 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 utilization management by adhering to… more
- Evolent (Des Moines, IA)
- …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 utilization management by adhering to Evolent and… more
- Baylor Scott & White Health (Des Moines, IA)
- …**SPECIALTY/DEPARTMENT:** Care Management: Case Management Utilization Management Appeals or grievances **SHIFT/SCHEDULE:** Full-time days, Monday-Friday, 8:00 ... vary based on position type and/or level **Job Summary** A Registered Nurse in Nursing Professional Development Generalist role uses expertise to enhance healthcare… more
- KidsPeace Childrens Hospital (Varina, IA)
- The Certified Registered Nurse Practitioner (CRNP) is responsible for overseeing the psychiatric needs of children, adolescents, and/or adults, with primary focus on ... conducting educational workshops and in service training for staff. The Nurse Practitioner will adhere to evidence-based practice guidelines, professional standards,… more
- Waverly Health Center (Waverly, IA)
- …on the Iowa Direct Care Worker Registry (Iowa Department of Inspections and Appeals Health Facilities Division). Completion of Nurse Aide II course preferred. ... and indirect patient care under the direction of a Registered Nurse or Licensed Practical Nurse . Assists licensed staff caring for patients with activities of… more
- Waverly Health Center (Waverly, IA)
- …on the Iowa Direct Care Worker Registry (Iowa Department of Inspections and Appeals Health Facilities Division). Completion of Nurse Aide II course preferred. ... scope of practice under the direction of a Registered Nurse . MINIMUM QUALIFICATIONS Education, Experience, and Training + Must...preferred. + Must have successfully completed a minimum of Nurse Aide I course and competency exams and be… more
- Molina Healthcare (Des Moines, IA)
- …responsibilities will include specialized medical necessity reviews and/or appeals and supporting market performance. Performance activities include physician ... medical necessity. + Participates in and maintains the integrity of the appeals process, both internally and externally. Responsible for the investigation of adverse… more
- Great River Health (West Burlington, IA)
- …and procedures, updating work flows as necessary. + Assist with appeals processes when authorizations are denied, providing necessary clinical information and ... Qualifications + Associate's Degree (AA) Current and active Registered Nurse (RN) license in good standing Required + 1-3...to maintaining a high standard of work. + Registered Nurse Iowa Board of Nursing (IBON) (United States of… more
- Southeastern Community College (West Burlington, IA)
- …the auspices of the Iowa Department of Inspections, Appeals , and Licensing-Division of Nursing. Responsibilities: Provide classroom/lab/clinical/simulation ... approved nursing program. + Must be a licensed Registered Nurse in the state of Iowa with an active...Ended Question) + * Are you currently a Registered Nurse with active and unencumbered licensure in the State… more
- WesleyLife (Urbandale, IA)
- …standards and performs regular chart audits. + Manages ADR reviews, insurance denial appeals , interim orders, and 485s. + **Client and Team Management** + Oversees ... Certifications** **Required** + Occupational Therapist + Physical Therapist + Registered Nurse **Experience** **Required** + 1 year: Full-time experience in home… more
- Trinity Health (Des Moines, IA)
- …for Medicare and Medicaid Services (CMS), Iowa Department of Inspections and Appeals (IDIA), The Joint Commission (TJC),etc.), in conjunction with the hospital's ... administration or related field required. + Iowa licensure as a Registered Nurse . + Member of a professional healthcare organization.Demonstrated expertise in the… more