- NHS Management (Prattville, AL)
- …accordance with the assessment and the plan of care . QUALIFICATIONS Must be a Registered Nurse in good standing in the state(s) in which assigned Must be ... the highest practicable level for each resident. Provides case management services for certain high-risk Medicare Part A residents...and restorative nursing, including medical practices in long term care Has a minimum two years experience in long… more
- Unknown (Reno, NV)
- …administrative role, 2 years of teaching in nursing programs, and 2 years of direct patient care as a registered nurse are required. The ideal candidate will ... to play a pivotal role in the leadership and management of the practical nursing program. The successful candidate...have a current RN license, experience in supervision, and a proven track… more
- Unknown (Boise, ID)
- …administrative role, 2 years' in teaching within nursing programs, and 2 years' as a registered nurse in direct patient care . The ideal candidate will have ... team, with a primary focus on the development and management of the nursing program. This role involves overseeing...Dean position must have a completed MSN, a current RN license, and a minimum of 2 years' experience… more
- Evolent (Springfield, IL)
- …as an RN - **Required** + Minimum of 5 years in Utilization Management , health care Appeals , compliance and/or grievances/complaints in a quality ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...Doing:** + Practices and maintains the principles of utilization management and appeals management by… more
- State of Colorado (Denver, CO)
- …Registered Nurse , Health Compliance Inspector Home Care - FAA00601 (HP III RN ) Print ... Apply Registered Nurse , Health Compliance Inspector Home Care - FAA00601 (HP III RN ) Salary $80,916.00 Annually Location Denver,… 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
- Rochester Regional Health (Rochester, NY)
- Job Title: Registered Nurse I Department: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 hours (Full-Time) Schedule: Monday - ... managed care payment principles helpful + Case Management Certification + At least 3 years RN...Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse -… more
- State of Colorado (Denver, CO)
- …III RN ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5190465) Apply Registered Nurse Health Compliance Inspector, Complaints ... Registered Nurse Health Compliance Inspector, Complaints...Section - FAA00731 (HP III RN ) Salary $80,916.00 Annually Location Denver, CO Job Type… more
- State of Colorado (Golden, CO)
- Registered Nurse I, RN ...to: healthy lifestyle ie diet, exercise, sleep hygiene, stress management , proper hygiene practices, dental care , STI's ... Mountain, Youth Services Center - Golden Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5185059) Apply Registered Nurse I, RN I -… more
- Elevance Health (Independence, OH)
- **Manager II Grievance/ Appeals - RN ** **Location** : Ohio-Cincinnati, Columbus, Mason, or Seven Hills ( _Must be within commutable distance to one of the listed ... is granted as required by law._ The **Manager II Grievance/ Appeals ** is responsible for management oversight of...and clinical services, quality of service and quality of care issues including executive and regulatory grievances. + Oversees… 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
- 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
- Nuvance Health (Danbury, CT)
- …in Milliman and InterQual Guidelines required * Minimum of 2-3 years experience as Utilization Management Nurse in an acute care setting required, minimum of ... *Description* *Summary:* The purpose of the Denial Prevention Nurse is to ensure that all patient admissions...and communicating on a daily/regular basis with the Denials Management team. * Assists with informing Managed Care… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Director Pre Appeals Management -HSO Appeals Management -Corporate 42nd Street-Full-Time-Days -Remote** The Director, Pre Appeals ... leader who provides strategic leadership and operational oversight for the hospital's pre- appeals management program. This role ensures the appropriate use of… more
- BronxCare Health System (Bronx, NY)
- …documents all telephone communications in accordance with department procedures using Care Management and other resources, escalates issues related to ... department physician advisors and clinical staff. Qualifications - NYS Registered Nurse required - The Appeal Manager...On the job or formal training in certified case management , denial and appeals management … more
- State of Colorado (Pueblo, CO)
- Nurse I - Registered Nurse I - CMHHIP Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5187654) 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
- University of Washington (Seattle, WA)
- …changes impacting revenue cycle **REQUIREMENTS** + Active licensure to practice as a Registered Nurse in Washington State + Bachelor's degree in Nursing + ... Medicine's Patient Financial Services Department** has an outstanding opportunity for a **Clinical Appeals and Disputes Nurse .** **WORK SCHEDULE** + 100% FTE +… more
- State of Colorado (Pueblo, CO)
- Registered Nurse II- CMHHIP Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5187078) 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
- CareFirst (Baltimore, MD)
- …complications. **QUALIFICATIONS:** **Education Level:** High School Diploma or GED. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure ... **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Nurse completes research, basic analysis,...Management at CareFirst BlueCross BlueShield, or similar Managed Care organization or hospital. + BSN/MSN Degree. **Knowledge, Skills… more
- CareFirst (Baltimore, MD)
- …experience is required in addition to the required work experience. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or Compact ... process for our membership, and support NCQA accreditation and the Divisional Goals for Care Management . We are looking for an experienced clinical leader in the… more
