- NavitsPartners (Boston, MA)
- Job Title: Travel - Registered Nurse ( RN ) - Case Management Location: Hyannis, MA Assignment Type: Travel Contract Duration: 13 Weeks Shift: Monday to Friday ... Total Weekly Compensation: $2,762 - $2,890 Position Overview: We are seeking an experienced Registered Nurse ( RN ) specializing in Case Management for a… more
- SUNSHINE ENTERPRISE USA LLC (Orange, CA)
- …of the position such as those listed above is also qualifying. Preferred Qualifications Active Registered Nurse ( RN ) license to practice in the state of ... Job Description Grievance & Appeals Nurse Specialist At Sunshine Enterprise...clinical issues. Managed care and health care industries. Appeals and grievance processes. At Sunshine Enterprise USA LLC,… more
- NYULMC (New York, NY)
- …Position Summary: We have an exciting opportunity to join our team as a Registered Nurse , Care Manager, Day Shift. In this role, the successful candidate ... News & World Report recently placed nine of its clinical specialties among the top five in the nation....Minimum Qualifications: To qualify you must have a Professional Registered Nurse in New York State with… more
- Beth Israel Lahey Health (Plymouth, MA)
- …to establish the appropriate level of care using Interqual criteria. Integrates clinical knowledge with billing knowledge to review, evaluate, and appeal clinical ... team to assess and improve the denial management, documentation, and appeals process. Collaborates with UR Manager and/or physician advisor regarding cases… more
- Tenet Health (West Palm Beach, FL)
- …reporting of data for other departments. Qualifications EDUCATION Graduate of Registered Nurse Program EXPERIENCE 2 years acute care RN experience LICENSE ... discharge planning of all acute clinical areas. Responsible for all insurance authorizations, clinical communication, and denial and appeals . Tracking and… more
- NavitsPartners (Hyannis, MA)
- Job Title: Registered Nurse - Case Management (Travel) Location: Hyannis, MA Job Type: Contract Pay: $70 - $80.03/hour | $3,201/week (Travel Rate) Schedule: 40 ... Weekend | Rotating Holidays Job Overview We are seeking a highly skilled and motivated Registered Nurse - Case Manager (Travel) to join a dynamic care team in… more
- University Hospitals (Beachwood, OH)
- …guidelines. (Required proficiency) CM software proficient. (Preferred proficiency) Licenses and Certifications Registered Nurse ( RN ), Ohio and/or Multi State ... reimbursement Perform timely and accurate review, denial communications and construct appeals , including remaining current with regulatory / payer and internal… more
- UofL Health (Louisville, KY)
- …Health experience (required for positions at Peace Hospital) Licensure: *Active Kentucky Registered Nurse License or compact license with privileges to work ... serve through compassionate, innovative, patient-centered care. The Utilization Review RN performs activities which support the Utilization Management functions.… more
- University of Iowa Hospitals & Clinics (Iowa City, IA)
- …Healthcare Downtown Campus, is looking for a Nurse Clinician to functions as a clinical nurse expert and clinical coordinator acting as nurse liaison ... by date of hire. 3 - 5 years of RN clinical nursing experience Excellent written and...Qualifications Professional Masters of Nursing and Healthcare Practice (MNHP), MSN/ Clinical Nurse Leader, or a Master's Degree… more
- Jaz Staffing Agency (Houston, TX)
- …of Social Work program. Licenses/Certifications: Current and valid license to practice as a Registered Nurse in the state of Texas or Current and valid license ... Facilitates patient care, with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care and… more
- Clarke County Hospital (Osceola, IA)
- …Preferred: Preferred Master's Degree in Nursing Experience: Preferred: Requires 5 years RN clinical hospital experience with minimum of 3 years management ... surgical services departments, staff development, front line staff orientation and nurse residency program that includes staff clinical competencies, standards… more
- Bryan Health (Lincoln, NE)
- …12. Ability to maintain regular and punctual attendance. EDUCATION AND EXPERIENCE: Current Registered Nurse licensure from the State of Nebraska or approved ... screening, insurance verification for benefits, medical necessity reviews, denial and appeals and coordinates admissions with the admitting physician and staff. Will… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- Ready to help us transform healthcare? Bring your true colors to blue. The RoleThe Clinical Appeals Nurse Reviewer is responsible for applying sound ... an integral part of the Appeal Review team, the Clinical Appeals Nurse Reviewer will...to assist with medical necessity determinations. Key Qualifications: + Registered Nurse with an active unrestricted professional… more
- Molina Healthcare (Midvale, UT)
- … decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical ... **JOB DESCRIPTION** _For this position we are seeking a ( RN ) Registered Nurse who must...with internet connectivity of high speed required._ **Job Summary** Clinical Appeals is responsible for making appropriate… more
- R1 RCM (Boise, ID)
- …platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals Nurse ** , you will help our ... position. **Here's what you will experience working as a Clinical Appeals Nurse :** + Conduct...at telephonic hearings if needed. **Required Skills:** + Active Registered Nurse license For this US-based position,… more
- Intermountain Health (West Valley City, UT)
- …write up clinical reviews for insurance audits and governmental insurance appeals using supporting documentation. 2. Assesses the appropriateness of clinical ... and Federal and State regulations. 3. Works with Physician Advisors to obtain clinical support for appeals if needed. 4. Collaborates with Care Management,… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …the direction of the **Utilization Management Appeals Professional, Registered Nurse ** is responsible for managing clinical denials and appeals . + ... **MINIMUM QUALIFICATIONS** : + License - Must have a valid, active unencumbered Registered Nurse license or temporary permit approved by the Georgia Licensing… more
- LifePoint Health (Hickory, NC)
- * Registered Nurse ( RN ), Clinical Case Manager* PRN * * *Your experience matters* At Frye Regional Medical Center, we are driven by a profound commitment ... prohibiting discrimination and harassment in employment." **Job:** **Nursing* **Organization:** ** **Title:** * Registered Nurse ( RN ), Clinical Case… more
- State of Colorado (Denver, CO)
- …(HP III RN ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5010527) Apply Registered Nurse , Complaints Health Compliance Inspector - ... Registered Nurse , Complaints Health Compliance Inspector -...FAA00438 (HP III RN ) Salary $80,916.00 - $90,648.00 Annually Location Denver, CO Job… more
- State of Colorado (Denver, CO)
- …(HP III RN ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5019261) Apply Registered Nurse Health Compliance Inspector Home Care - ... Registered Nurse Health Compliance Inspector Home Care -...FAA00094 (HP III RN ) Salary $80,916.00 Annually Location Denver, CO Job Type Full Time… more
