• RN UM Clinical Appeals

    Molina Healthcare (Atlanta, GA)
    **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal appeals clinical processes - ensuring that ... to provide quality and cost-effective member care. Candidates with UM and Appeals experience are highly preferred...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/14/25)
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  • Appeals Nurse Consultant

    CVS Health (Atlanta, GA)
    …with heart, each and every day. **Position Summary** CVS Aetna is seeking a dedicated ** Appeals Nurse Consultant** to join our remote team. In this role, you ... critical role in ensuring fair and accurate resolution of clinical appeals by applying sound clinical...UM (includes expedited), MPO, Coding, or Behavioral Health appeals . + This is a full-time telework position with… more
    CVS Health (11/08/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Atlanta, GA)
    For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... (Team will work on set schedule) Looking for a RN with experience with appeals , claims review,...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/01/25)
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  • RN Care Review Clinician Remote

    Molina Healthcare (Atlanta, GA)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... Summary** The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for verifying that services are… more
    Molina Healthcare (11/09/25)
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