- Providence (Torrance, CA)
- **Description** ** Appeals RN - Care Manager...Degree Nursing. + Upon hire: California Registered Nurse License. + 2 years Direct patient care ... Per Diem and will work 8-hour, Day shifts.** The Care Management Recovery Advocate (CMRA) is responsible...management certification. + Experience working with denials and appeals in/for an acute care setting. +… more
- MVP Health Care (Schenectady, NY)
- …terminology, healthcare procedures, and clinical guidelines. + Previous experience in clinical appeals , utilization management or managed care and LTSS ... At MVP Health Care , we're on a mission to create a...To achieve this, we're looking for a **Professional, Clinical Appeals RN ** to join #TeamMVP. This is… 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
- McLaren Health Care (Grand Blanc, MI)
- …including role, responsibilities tools, and methodologies. _Required:_ + State licensure as a Registered Nurse ( RN ) + Bachelor's degree in nursing from ... experience + Five years of clinical nurse experience in an acute care setting + American Case Management Certification (ACM) or obtain certification when… more
- State of Colorado (Denver, CO)
- …III RN ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5120373) Apply Registered Nurse Health Compliance Inspector, Nursing ... Registered Nurse Health Compliance Inspector, Nursing...Facilities - FAA00221 (HP III RN ) Salary $80,916.00 Annually Location Denver, CO Job Type… 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:... appeals and grievances experience in a managed care , utilization management and/or case management… more
- Walgreens (Deerfield, IL)
- …for customers, patients, team members and communities. **Job ID:** 1655228BR **Title:** Registered Nurse ( RN ) Specialty **Company Indicator:** Walgreens ... to: Infusion Care , Fertility Order, Nursing Network, Care Management . + May have other responsibilities...Associate's degree in Nursing + Current license/registration as an RN ( Registered Nurse ) with the… more
- Molina Healthcare (Salt Lake City, UT)
- **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal appeals clinical processes - ensuring that appeals ... to overarching strategy to provide quality and cost-effective member care . Candidates with UM and Appeals experience...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Commonwealth Care Alliance (Boston, MA)
- … care management and care delivery. Within the CIC Program, the Registered Nurse ( RN ) serves as an integral member of an interdisciplinary team ... committees and workgroups that promote clinical excellence. The CIC RN May also conduct ** Care Management... management , including: + 5+ years' experience as Registered Nurse in a high touch clinical… more
- Sacramento County (Sacramento, CA)
- Supervising Registered Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448883) Apply Supervising Registered Nurse ... 5:00 pm on: 12/1/25, 2/2/26, 4/6/26, 6/1/26, 8/3/26, 10/5/26, 12/7/26 Supervising Registered Nurse - Detention/Correctional Facility is the first level… more
- St. Luke's University Health Network (Allentown, PA)
- …the 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
- State of Colorado (Pueblo, CO)
- Registered Nurse I - Nursing Residency...care within a safe and secure environment. The RN Residency Program is a one-year program that encompasses ... Program - CMHHIP - Pueblo Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5145740) Apply Registered Nurse I - Nursing Residency Program -… more
- Cognizant (Annapolis, MD)
- …expectations. **What you need to have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact... management experience with managed health care plan . 3 years' experience in health … more
- CommonSpirit Health (Centennial, CO)
- …to help you flourish and leaders who care about your success. The RN Clinical Denials Appeals Specialist functions as a revenue management liaison ... BSN required Minimum Experience required: 4 years clinical experience as a Registered Nurse . 3 years with progressive experience in utilization review,… more
- HCA Healthcare (Nashville, TN)
- …VA). Do you want to join an organization that invests in you as a Clinical Appeals Specialist Medicare RN or LPN? At Parallon, you come first. HCA Healthcare has ... and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. +...a difference. We are looking for a dedicated Clinical Appeals Specialist Medicare RN or LPN like… more
- State of Colorado (Pueblo, CO)
- Nurse I - Registered Nurse I - CMHHIP Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5130579) Apply Nurse I - Registered ... closing date and time listed. + Description + Benefits + Questions Department Information Registered Nurse I-Full Time CMHHIP This posting will be used to fill… more
- McLaren Health Care (Port Huron, MI)
- …related duties as required and directed. **Qualifications:** Required ⦁ State licensure as a registered nurse ( RN ) ⦁ Bachelor's degree in nursing from ... entry for timeliness, appropriateness and completeness as pertains to the utilization management process including level of care , medical necessity, and… 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/5078182) Apply ... Registered Nurse I-Colorado Mental Health Hospital in...as individual counseling, psychoeducational and teaching groups, and milieu management + Communicates the nursing plan of care… 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
- Cedars-Sinai (CA)
- …as a condition of continued employment. **Req ID** : 13443 **Working Title** : Registered Nurse Care Coordinator- Inpatient Specialty Program - 8 Hour ... Science degree in Nursing required **License/Certifications:** + Valid CA RN license required + Certified Case Management ...nursing (Medical Surgical/Tele/ICU) with 2 or more year of care management experience (UM or DC Planning).… more