- Williamson Health (Nolensville, TN)
- …/ Training: Must be currently licensed by the State of Tennessee as a Registered Nurse . Emergency Room and or Critical Care preferred Case Management ... care team, focusing on resource management and discharge planning. Performs timely review and delivery of necessary clinical information according to… more
- St. Luke's University Health Network (Allentown, PA)
- …communities we serve, regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient ... Works inside with adequate lighting, comfortable temperature and ventilation. EDUCATION: Registered Nurse required, BSN preferred. Current license required. .… more
- University of Washington (Seattle, WA)
- …**UW Medicine's Patient Financial Services Department** has an outstanding opportunity for a ** Clinical Appeals and Disputes Nurse .** **WORK SCHEDULE** + ... FTE + 100% Remote + Days **POSITION HIGHLIGHTS** The Clinical Appeals and Disputes Nurse ...and communicated payer decisions in a timely manner + Review clinical denials and initiate appeals… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse ( RN ) Manager, Appeals and Grievances General Operations ( Clinical ) Job Category: Clinical Department: CSC Appeals & ... + Excellent verbal, written communication and presentation skills. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and… 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: Clinical Department: CSC ... unit. This position is responsible for the quality review of complex and/or escalated clinical A&G… more
- Nuvance Health (Danbury, CT)
- *Description* *Summary:* The purpose of the Denial Prevention Nurse is to ensure that all patient admissions are appropriately status within the first 12-24 hours ... critical part in preventing payment denials by providing timely and accurate clinical information to all payers, while ensuring compliance with CMS requirements,… more
- State of Colorado (Denver, CO)
- …(HP III RN ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5183355) Apply Registered Nurse , Health Compliance Inspector Home Care - ... health, safety, and well-being of Colorado communities. As a Registered Nurse ( RN ) Health Professional...through direct observation, staff and consumer interviews, and record review . + Applying professional judgment and clinical … more
- BayCare Health System (Clearwater, FL)
- …Qualifications:** + 2 years of experience with case management and/or clinical appeals or claims. + Registered Nurse **Facility:** BayCare Health System, ... review processes including how to analyze and research clinical issues and the appeals and grievance...be working remotely?** Hybrid Equal Opportunity Employer Veterans/Disabled **Position** Clinical Appeals Nurse - Health… more
- State of Colorado (Grand Junction, CO)
- Registered Nurse I, RN I - Grand Mesa Youth Services Center Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5177091) Apply ... Registered Nurse I, RN I...including physical, psychiatric and dental maintenance. Specific Job Duties: Clinical Duties: Initial nursing assessments and triage of requests… more
- Rochester Regional Health (Rochester, NY)
- …BLS - Basic Life Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse - New York State Education Department ... Job Title: Registered Nurse I Department: Utilization Management...review findings, initiate and 1st, 2nd, and/or arbitration appeals as needed. Document in all areas that an… more
- Cognizant (Salem, OR)
- …to be considered** + Educational background - Registered Nurse ( RN ) + 2-3 years combined clinical and/or utilization management experience with managed ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...as well as timely filing deadlines and processes. + Review clinical denials including but not limited… more
- BronxCare Health System (Bronx, NY)
- …by the department physician advisors and clinical staff. Qualifications - NYS Registered Nurse required - The Appeal Manager must have excellent verbal and ... and electronic format. Collaborating with the Department Denial and Appeals Coordinators, Physician Advisors, and the clinical ...preferred. -The Appeal Manager should have experience as a nurse in acute care clinical setting who… more
- Evolent (Springfield, IL)
- …to Standard processing, documenting accordingly. + Works closely with the appeals -dedicated Clinical Reviewers to ensure timely adjudication of processed ... for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a...work with a group of nurses, providing appeal intake review for one dedicated client. They interact with coordinators… more
- Elevance Health (FL)
- ** Nurse Appeals - Litigation & Legal Support** **In Office Expectation:** This role is **Virtual** ; This role enables associates to work virtually full-time, ... necessary and is dependent on court hearing schedules. The ** Nurse Appeals - Litigation & Legal Support**...including ensuring accurate entry, investigation, and analysis of state appeals ; summarizing medical information for review by… more
- State of Colorado (CO)
- CDOC Registered Nurse ( Nurse I) Print...RN license. 07 Do you possess an active RN license issued by an Enhanced Nurse Licensure ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5123731) Apply CDOC Registered Nurse ( Nurse I) Salary $7,591.00 - $10,627.00 Monthly… 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...updates on CDHS recruiting events! CDHSCareers Description of Job RN Residency Program Objective: This position will provide novice… 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...+ Use and care of medical equipment used in clinical and infirmary settings + Basic medical indications of… more
- State of Colorado (Pueblo, CO)
- Nurse I - Registered Nurse...This position is responsible for assisting nursing staff with clinical direction of nursing staff, QA/PI activities and to ... - CMHHIP Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5130579) Apply Nurse I - Registered Nurse I - CMHHIP Salary $43.80 - $61.31… more
- State of Colorado (Denver, CO)
- Registered Nurse I-Colorado Mental Health Hospital in Fort Logan-Denver Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5166359) Apply ... Registered Nurse I-Colorado Mental Health Hospital in...and competencies necessary to the position through continuing education, clinical supervision, literature review , and participating in… more
- State of Colorado (Pueblo, CO)
- Registered Nurse II- CMHHIP Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5130585) Apply Registered Nurse II- CMHHIP Salary ... closing date and time listed. + Description + Benefits + Questions Department Information Registered Nurse II-Full Time CMHHIP This posting will be used to fill… more
