- Unknown (Reno, NV)
- …2 years of teaching in nursing programs, and 2 years of direct patient care as a registered nurse are required. The ideal candidate will have a current RN ... The role also demands a commitment to diversity, the ability to manage student appeals and grievances, and a proactive approach to maintaining the quality of… more
- Unknown (Reno, NV)
- …teaching in nursing programs, and direct patient care as a registered nurse . The role requires a current RN license, experience in supervision, planning, ... well as actively participating in nursing faculty meetings and ensuring the quality of instruction through program review and strategic planning. Applicants must… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse ( RN ) Manager, Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances ... + Excellent verbal, written communication and presentation skills. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and… more
- Elevance Health (Columbus, OH)
- ** Nurse Appeals RN ** **Location** :...skills and serves as a subject matter expert for appeals /grievances/ quality of care issues and is a resource ... an accommodation is granted as required by law._ The ** Nurse Appeals ** is responsible for investigating and...would provide an equivalent background. + Current active unrestricted RN license to practice as a health professional within… more
- Elevance Health (Tampa, FL)
- ** Nurse Appeals ** **Hybrid 1:** This role...skills and serves as a subject matter expert for appeals /grievances/ quality of care issues and is a ... an accommodation is granted as required by law._ The ** Nurse Appeals ** is responsible for investigating and...would provide an equivalent background. + Current active unrestricted RN license to practice as a health professional within… more
- LA Care Health Plan (Los Angeles, CA)
- …the ability to manage multiple training initiatives simultaneously. Licenses/Certifications Required Licensed Registered Nurse ( RN ) - Active, current and ... Lead Customer Solution Center Appeals and Grievances RN Job Category:...Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and… more
- Adecco US, Inc. (Minneapolis, MN)
- Adecco Healthcare & Life Sciences is hiring remote RN Appeals Reviewers! This role is remote / work from home. Please read below and apply with an updated resume ... **Pay:** $40.50 to $42.50 an hour **Responsibilities of the RN Appeals Reviewer:** . Responsible for conducting...and Holiday pay upon meeting eligibility criteria. **IMPORTANT:** This ** Registered Nurse ** role is being recruited for… more
- State of Colorado (Denver, CO)
- …(HP III RN ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5155064) Apply Registered Nurse Health Compliance Inspector Home Care - ... health, safety, and well-being of Colorado communities. As a Registered Nurse ( RN ) Health Professional..., you will use your clinical expertise to ensure quality of care, protect patient rights, and promote excellence… more
- Elevance Health (Cleveland, OH)
- ** Nurse Appeals -Licensed Nurse **...entities, and serves as a subject matter expert for appeals , grievances, and quality of care issues. ... necessary and is dependent on court hearing schedules. 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
- St. Luke's University Health Network (Allentown, PA)
- …Works inside with adequate lighting, comfortable temperature and ventilation. EDUCATION: Registered Nurse required, BSN preferred. Current license required. . ... serve, regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records,… more
- State of Colorado (Grand Junction, CO)
- Registered Nurse I, RN I...of the department's action. For more information about the appeals process, the official appeal form, and how to deliver ... - Grand Mesa Youth Services Center Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5157862) Apply Registered Nurse I, RN I - Grand… more
- CareFirst (Baltimore, MD)
- …strategies to improve individual and team-based performance as needed. **Licenses/Certifications** : + RN - Registered Nurse - State Licensure And/or Compact ... **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Supervisor directs and coordinates the accurate implementation of the clinical appeal process for members… more
- Community Health Systems (Franklin, TN)
- …of insurance claims processing and denial management workflows. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact ... and supports initiatives that improve denial prevention and recovery processes. As an Appeals Specialist II at Community Health Systems (CHS) - SSC Nashville, you'll… more
- AmeriHealth Caritas (Philadelphia, PA)
- …process, preferably within a managed care organization **Licensure:** + Current and unrestricted Registered Nurse ( RN ) licensure or compact state licensure ... **Role Overview: ;** The Clinical Appeals Reviewer is responsible for processing appeals...state, and local regulations, such as the National Committee Quality Assurance (NCQA) standards related to appeal and grievance… more
- Centene Corporation (Trenton, NJ)
- …State Licensure required or + LVN - Licensed Vocational Nurse required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure ... Zone.** **Position Purpose:** Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical… more
- Centene Corporation (Jefferson City, MO)
- …State Licensure required or + LVN - Licensed Vocational Nurse required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure ... **Position Purpose:** Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical… more
- University of Washington (Seattle, WA)
- …Medical Center-Montlake - Endocrine Care Center** has an outstanding opportunity for a ** Registered Nurse .** **WORK SCHEDULE** + 40 hours per week + ... - this position will be the only full time RN on the team **PRIMARY JOB RESPONSIBILITIES** + Provide...nursing experience + Active licensure to practice as a Registered Nurse in Washington State + Active… more
- BronxCare Health System (Bronx, NY)
- …special projects and committees as determined by Director. Qualifications CERTIFICATION/LICENSURE : Registered Nurse or physician or a foreign medical graduate ... the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute care services provided to… more
- State of Colorado (Pueblo, CO)
- Registered Nurse I - Nursing Residency Program - CMHHIP - Pueblo Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5145740) Apply ... Registered Nurse I - Nursing Residency Program...in Pueblo (CMHHIP) is a leading employer, provider of quality mental health services, and a community partner. CMHHIP… more
- Sacramento County (Sacramento, CA)
- …read and understood the above instructions. 02 Select the one box that best describes your Registered Nurse ( RN ) license issued by the State of California. + ... Registered Nurse D/CF (Level I/II) Print...examination will evaluate the relevance, level, recency, progression and quality of candidate's education, training and experience. The candidate's… more
