- Elevance Health (Woodland Hills, CA)
- ** Nurse Appeals - Licensed Nurse ** **Location:** *The ideal candidate must reside in the state of California and live within 50 miles of our Woodland Hills ... **Shift:** Monday to Friday from 8:00-5:00 pm PT The ** Nurse Appeals ** is responsible for investigating and...which would provide an equivalent background. Current active unrestricted RN license to practice as a health professional within… more
- Elevance Health (Woodland Hills, CA)
- ** Nurse Appeals - California candidates only** **Location: This is a virtual position and prefer candidates reside within 50 miles of an Elevance Health ... make an impact:** Responsible for investigating and processing and medical necessity appeals requests from members and providers. **Primary duties may include, but… more
- Elevance Health (Woodland Hills, CA)
- …in interpreting appropriateness of care and accurate claims payment. May also manage appeals for services denied. **How You Will Make an Impact:** + Conducts ... which would provide an equivalent background. + Requires current active unrestricted RN license to practice as a health professional in applicable state(s) or… more
- Elevance Health (Woodland Hills, CA)
- …in interpreting appropriateness of care and accurate claims payment. May also manage appeals for services denied. **How You Will Make an Impact:** . Conducts ... requirements and standards **Required Qualifications:** . Requires current active unrestricted RN license to practice as a health professional within the scope… more
- Prime Healthcare (Ontario, CA)
- …Utilization Review or Case Management with a large Health Plan + An active CA Registered Nurse license + Current BCLS (AHA) certificate upon hire and maintain ... Service, to provide guidance on complex Authorizations, Referrals, Denials and Appeals . + Integrates and coordinates services using continuous quality improvement… more