- CVS Health (Hartford, CT)
- …+ Basic awareness of problem solving and decision making skills Position Summary The Appeals Nurse Consultant position is responsible for processing the ... Position OverviewAdministers review and resolution of clinical complaints and appeals . Interprets data obtained from clinical records to apply...a production role and remains as part of the Nurse Appeal Consultant job code. Primary duties… more
- CVS Health (Hartford, CT)
- …of residence with occasional rotational weekend and holiday coverage. Position Summary The Appeals Nurse Consultant position is responsible for processing ... the medical necessity of Medicare Part C appeals from both members and providers. This role is...a production role and remains as part of the Nurse Appeal Consultant job code. Primary duties… more
- CVS Health (Hartford, CT)
- …US. Standard business hours 8a-5p in time zone of residence Monday - Friday. The Appeals Nurse Consultant position is responsible for processing the medical ... necessity of Medicare appeals for participating providers. Primary duties may include, but are not limited to: Requesting clinical, research, extrapolating pertinent… more
- Amgen (Indianapolis, IN)
- …Must be able to effectively collaborate across all corporate functions-MSLs, TLLs, Nurse Coordinators, Field Access Team, supporting sales teams, etc. + Key account ... by better understanding the customer's needs + Serves as a resource/ consultant to customers and staff regarding payer policies and processes (eligibility… more
- Centene Corporation (Trenton, NJ)
- …Develop and maintain the audit process and tools related to: authorizations, appeals , quality events, and case management in CCMS; interrater reliability related to ... and tools + Facilitate compliance with the auditing process + Act as a consultant related to system auditing to others in the unit, department and health plan… more