- Cognizant (Columbus, OH)
- …need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...clinic operations . Experience in utilization management to include Clinical Appeals and Grievances, precertification, initial and… more
- CVS Health (OH)
- … resolutions with internal and external support areas. **Required Qualifications** + A Registered Nurse that must hold an unrestricted license in their state ... quality care for members. Administers review and resolution of clinical complaints and appeals . Interprets data obtained from clinical records to… more
- Molina Healthcare (Akron, OH)
- …resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training and support to clinical ... (Team will work on set schedule) Looking for a RN with experience with appeals , claims review, and medical coding. **Job Summary** Utilizing clinical knowledge… more