- 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
- LA Care Health Plan (Los Angeles, CA)
- …The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist Registered Nurse ( RN ) II provides direct assistance to member's with ... Customer Solution Center Appeals and Grievances Nurse Specialist RN II Job Category:...participating provider groups, and other external agencies. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- LA Care Health Plan (Los Angeles, CA)
- …an enthusiastic team player. Must be able to work independently. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Supervisor, Appeals and Grievances Clinical Operations RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017… 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
- LA Care Health Plan (Los Angeles, CA)
- …accreditation guidelines and standards preferred. Licenses/Certifications Required Licenses/Certifications Preferred Registered Nurse ( RN ) - Active, current ... with the Chief Operating Officer (COO) to allow for integration with claims, appeals and grievances, and our customer service center. The COE ensures regulatory… more