- Molina Healthcare (Tampa, FL)
- …for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical /medical ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions… more
- Aerotek (Tampa, FL)
- **Description** PURPOSE: The Clinical Appeals Specialist completes research basic analysis and evaluation of member and provider disputes regarding adverse and ... adverse coverage decisions. The Clinical Appeals Specialist utilizes clinical ...and all External appeal rights. Licenses/Certifications RN - Registered Nurse - State Licensure And/or Compact State Licensure Upon… more
- Elevance Health (Tampa, FL)
- ** Nurse Appeals - Medicare** **Location:** Virtual:.../grievances/quality of care issues and is a resource for clinical and non clinical team members in ... shifts from Tuesday to Saturday and coverage on certain holidays. The ** Nurse Appeals - Medicare** is responsible for investigating and processing and medical… more
- BayCare Health System (Tampa, FL)
- …responsibility and clinical excellence. **Are you a passionate and dedicated Nurse Care Coordinator, RN seeking a flexible work schedule and the chance to ... our care team. This vital role blends patient-facing responsibilities with clinical coordination and administrative duties, supporting a diverse patient population.… more