- RestoraCare Staffing (Houston, TX)
- RestoraCare Staffing is seeking a Registered Nurse ( RN ) Case Management for a nursing job in Houston, Texas.Job Description & RequirementsSpecialty: Case ... Licenses/Certifications: Current and valid license to practice as a Registered Nurse in the state of Texas...cost per case, excess days, resource utilization, readmission rates, denials and appeals. Uses data to drive decisions and… more
- AdventHealth (Tampa, FL)
- …Stroke Center. **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing ... admission, treatment, and appropriate level of care. The UM RN leverages the algorithmic logic of the XSOLIS Cortex.... Current and valid license to practice as a Registered Nurse (ADN or BSN) required. .… more
- Houston Behavioral Healthcare Hospital (Houston, TX)
- …safety. Houston Behavioral Healthcare Hospital is currently recruiting for full-time Intake Registered Nurse , 12hr shifts including alternating weekends. The MOT ... Intake Registered Nurse is primarily responsible managing the...Intake Registered Nurse is primarily responsible managing the MOT process The...for admission. + Notifies Director of Intake of any denials of admissions + The RN must… more
- AdventHealth (Hinsdale, IL)
- …resolution skills . Teamwork principles **EDUCATION AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse ( RN ) . ... **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** . State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:**… more
- AdventHealth (Hinsdale, IL)
- …skills **.** Teamwork principles **EDUCATION AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse ( RN ) . ... **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** **.** State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:**… more
- AdventHealth (Ocala, FL)
- …need to succeed** **:** **REQUIRED:** EDUCATION AND EXPERIENCE REQUIRED: * Associates Degree Nursing or RN Diploma degree * Registered Nurse ( RN ) * Two ... patients who no longer meet medical necessity and escalates potential denials , documents avoidable days, and facilitates progression of care. Participates in… more
- Geisinger (Bloomsburg, PA)
- …and License(s) Basic Life Support Certification - Default Issuing Body; Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE & ... administrative and medical channels to avoid third party payer denials . + Maintains awareness of all concurrent denials...but not required. + Required Experience: 3 years of RN work experience + To learn more about Geisinger… more
- AdventHealth (Orlando, FL)
- …Degree Nursing + Current valid State of Florida or multistate license as a Registered Nurse + 2 years of medical/ hospital nursing experience **Preferred ... inpatients and 125,000 outpatients each year **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses,… more
- Ascension Health (Pensacola, FL)
- …rules and regulations. **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse credentialed from the Florida Board of Nursing ... obtained prior to hire dateor job transfer date required. Licensed as a Registered Nurse in Florida required. Credentialed from State Board ofNursing or current… more
- Ascension Health (Nashville, TN)
- …/ Certification / Registration: + One or more of the following required: + Registered Nurse credentialed from the Tennessee Board of Nursing or current home ... with your Talent Advisor for additional specifics._ **Responsibilities** Coordinate payer denials and appeals, respond to insurance company requests for medical… more
- Catholic Health Initiatives (Omaha, NE)
- …as assigned by the manager. **Qualifications** **Required:** + Minimumthree (3)yearsclinical experience as Registered Nurse ( RN ) required. + RN license ... **Overview** The Denials RN is responsible and accountable for receiving, processing and documenting all concurrent denials for assigned facilities. The … more
- Ascension Health (Wichita, KS)
- …rules and regulations. **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse credentialed from the Kansas Board of Nursing ... related to coding, medical records/documentation, precertification, reimbursement and claim denials /appeals. + Assess and coordinate discharge planning needs with… more
- Bon Secours Mercy Health (Boardman, OH)
- …operational excellence. **Summary of Primary Function/General Purpose of Position** The RN Outpatient Wound Care performs and documents complete patient assessments, ... including scheduling, registration, clinical coverage/treatment, documentation, billing, collections, and denials . * Assists leadership to perform auditing to ensure… more
- Ascension Health (Glendale, WI)
- …and identify savings potential. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Wisconsin Board of Nursing ... with your Talent Advisor for additional specifics._ **Responsibilities** Coordinate payer denials and appeals, respond to insurance company requests for medical… more
- Ascension Health (Birmingham, AL)
- …Specialists obtained prior to hire date or job transfer date required. + Registered Nurse credentialed from the Alabama Board of Nursing obtained prior ... the following qualities: 4-5 years of CDI experience CCDS certification Denials experience NCD/LCD Denial prevention Strong knowledge in HACs/PSI **Benefits** Paid… more
- Trinity Health (Farmington Hills, MI)
- …**MINIMUM QUALIFICATIONS** Must possess a demonstrated knowledge of denial management functions. Registered Nurse and a graduate of an accredited school of ... Work Remote Position (Pay Range: $34.9314-$52.3971) Responsible for reviewing all post-billed denials (inclusive of clinical denials ) for medical necessity and… more
- Penn Medicine (Plainsboro, NJ)
- …reimbursement, proactively identify potential denials in order to avoid non-appealable denials ; Credentials: + Registered Nurse - NJ (Required) + ... Certified Case Manager (Required) + National Case Management certification preferred; or obtained within two years of employment. Education or Equivalent Experience: + Bachelor of Arts or Science (Required) + BSN degree required Minimum of 3 years… more
- Actalent (Rancho Mirage, CA)
- …requirements. This position complies with the scope of services defined by the Registered Nurse RN state licensure requirements. This position integrates ... using the data to address opportunities for improvement. Prevents denials and disputes by communicating with payers and documenting...Registered Nurse Additional Skills & Qualifications: Registered Nurse - RN About… more
- Sharp HealthCare (San Diego, CA)
- …Certification; Accredited Case Manager (ACM) - American Case Management Association (ACMA); California Registered Nurse ( RN ) - CA Board of Registered ... or equivalent experience in the healthcare setting. + California Registered Nurse ( RN ) - CA...organization goals including reductions in length of stay, decreasing denials , improvement of care transitions, and reduction in avoidable… more
- Billings Clinic (Billings, MT)
- …Licenses * Healthcare Provider CPR Certification At hire * Current Montana license as a Registered Nurse At hire * Current working knowledge of payer and managed ... starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN CARE MANAGEMENT (Billings Clinic Main Campus) req7327 Shift:… more
