- Denver Health (Denver, CO)
- …Must Be a Colorado Resident Job Summary Under minimal supervision, the Registered Nurse , Grievance & Appeals is responsible for assessing and completing ... care health insurance plan required . Previous grievance and appeals experience preferred. Licenses : RN - Registered Nurse - DORA - Department of… more
- EmblemHealth (New York, NY)
- Summary of Position Perform clinical and administrative reviews within the Grievance and Appeals department, ensuring accurate administration of benefits, ... timely and professional manner. Maintain an understanding of utilization management/ grievance and appeals program objectives and design, implementation,… more
- Blue Shield of California (Long Beach, CA)
- Job Description Work Schedule M-Th 10:30-7:00 F 9:30-6:00 Your Role The Behavioral Health Registered Nurse Case Manager will report to the FEP Department ... plan type Provide Referrals to Quality Management (QM), Disease Management (DM) and Appeals and Grievance department (AGD) Recognize the clients right to… more
- Blue Shield of California (Rancho Cordova, CA)
- …involved with members care including clinical nurses and treating MDs.. The Case Management Nurse , Senior will report to the Manager , Care Management. In this ... Referrals to Quality Management (QM), Disease Management (DM) and Appeals and Grievance department (AGD) Recognize the...Qualifications Your Knowledge and Experience Requires a current CA RN License Bachelors of Science in Nursing or advanced… more
- Elevance Health (Tampa, FL)
- ** Nurse Appeals - Medicare** **Location:** Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training ... an accommodation is granted as required by law. The ** Nurse Appeals - Medicare** is responsible for...timely to meet regulatory timeframes. + Documents and logs appeal/ grievance information on relevant tracking systems and mainframe systems.… more
