- CVS Health (Hartford, CT)
- …day. **Position Summary** Responsible for the review and resolution of clinical appeals . Reviews documentation and interprets data obtained from clinical records to ... as required. This position may support UM, MPO, Coding, or Behavioral Health appeals . **Required Qualifications** * Must have active and unrestricted RN licensure in… more
- CVS Health (Columbus, OH)
- …Utilization Management (UM) Nurse to join our remote team. **Position Summary** The Appeals Nurse Consultant plays a key role in resolving clinical ... complaints and appeals by reviewing medical records and applying clinical guidelines...clinical resolutions with internal and external support areas. **Remote Work Expectations** + This is a 100% remote role;… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding ... adverse and adverse coverage decisions. The Clinical Appeals Nurse utilizes clinical skills and knowledge...Case Manager Upon Hire Preferred + LNCC - Legal Nurse Consultant Certified Upon Hire Preferred **Experience:**… more
- CareFirst (Baltimore, MD)
- …+ CCM - Certified Case Manager Upon Hire Preferred. + LNCC - Legal Nurse Consultant Certified Upon Hire Preferred. **Experience:** 5 years medical-surgical or ... experience is required in addition to the required work experience. **Licenses/Certifications:** + RN - Registered Nurse...and understanding of medical terminology. + Understanding of the appeals process and ability to work independently… more
- Sacramento County (Sacramento, CA)
- Registered Nurse D/CF (Level I/II) Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/454059) Apply Registered Nurse D/CF (Level I/II) ... pm on: 9/4/2025, 11/6/2025, 1/2/2026, 3/5/2026, 5/7/2026, 7/2/2026, 9/3/2026, 11/5/2026 Registered Nurse D/CF Level I: $62.99 - $76.57 hourly Registered Nurse … more
- Sacramento County (Sacramento, CA)
- Licensed Vocational Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448956) Apply Licensed Vocational Nurse D/CF Salary ... 4/3/2026, 7/2/2026, 10/2/2026 In a detention/correctional facility, the Licensed Vocational Nurse D/CF performs a wide variety of vocational nursing duties,… more
- Sacramento County (Sacramento, CA)
- …+ Basic psychotropic drugs, and their usage. + Basic terminology of psychiatric social work . + Gross anatomy. + Basic medical terminology. Ability To + Establish and ... + Recognize changes in patient's condition or behavior. + Work effectively as a member of a mental health...as a: Either: 1. Psychiatric Technician Or: 2. Registered Nurse Or: 3. Vocational Nurse Note: The… more
- City and County of San Francisco (San Francisco, CA)
- …of diversity in its workforce. All employees at the Department of Public Health work to advance equity, inclusion, and diversity with a specific lens and focus on ... Franciscans. SFDPH strives to achieve its mission through the work of two main Divisions - the San Francisco...as a Licensed Psychiatric Technician or a Licensed Vocational Nurse providing psychiatric nursing care in a skilled facility… more