- Elevance Health (Nashville, TN)
- ** Nurse Appeals RN - Quality of Care** **Hybrid 1:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and ... Hours:** Monday-Friday, 8:00AM -5:00 PM Eastern Standard Time The ** Nurse Appeals ** is responsible for investigating and...and summarizes medical information for medical director. + Prepares nurse summaries for Quality of Care cases… more
- Evolent (Nashville, TN)
- …**Required** + Minimum of 5 years in Utilization Management, health care Appeals , compliance and/or grievances/complaints in a quality improvement environment- ... for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a...part of a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of… more
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Appeals Nurse 2 resolves clinical complaints and appeals . The Appeals Nurse ... independent determination of the appropriate courses of action. The Appeals Nurse 2 reviews documentation and interprets... RN license + 3 years of clinical RN Experience + Appeals nursing experience +… more
- HCA Healthcare (Nashville, TN)
- … appeals , denials, managed care contracting, experienced preferred. + Currently licensed as a registered nurse ( RN ) in the state(s) of practice and/or has ... to join an organization that invests in you as an Inpatient Authorization Review Services Registered Nurse or Licensed Practical Nurse -NICU (Code Pink)? At… more