- HCA Healthcare (San Antonio, TX)
- **Description** **Introduction** Do you have the career opportunities as a Clinical Appeals Nurse you want with your current employer? We have an exciting ... a committed, caring group of colleagues. Do you want to work as a Clinical Appeals Nurse where your passion for creating positive patient interactions is… more
- Molina Healthcare (San Antonio, TX)
- …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
- Molina Healthcare (San Antonio, TX)
- …Director for Specialty Medical Services & Market Performance will provide clinical expertise and support to the enterprise. Primary responsibilities will include ... specialized medical necessity reviews and/or appeals and supporting market performance. Performance activities include physician auditing, training, and performance… more
- Molina Healthcare (San Antonio, TX)
- …state, and local laws and regulatory requirements affecting the medical and clinical staff. **Job Duties** + Provides medical oversight and expertise in ... medical necessity. + Participates in and maintains the integrity of the appeals process, both internally and externally. Responsible for the investigation of adverse… more