- Williamson Health (Murfreesboro, TN)
- …/ Training: Must be currently licensed by the State of Tennessee as a Registered Nurse . Emergency Room and or Critical Care preferred Case Management ... in patient conversations and delivery of information related to discharge choices/discharge appeals and actively facilitates in the Discharge Appeals process.… more
- Bluestone Child & Adolescent Psychiatric Hospital (University Heights, OH)
- …guidelines. Complete all data tracking as needed. Perform all duties of the Psychiatric Nurse ( RN /LPN) role as needed or when assigned by management. OTHER ... Psychiatric Intake Nurse - FT Nights, 5-8 hour shifts- Sunday through...Master's degree in related field preferred. Licensure: Valid Ohio RN /LPN license required. Skills: Sensitivity in relating to persons… more
- NewYork-Presbyterian (Brooklyn, NY)
- Discover Where Amazing Works Case Manager - RN - Inpatient Units- Brooklyn Methodist - Days Located in Park Slope, Brooklyn, this acute-care teaching hospital has ... admissions that requires risk identification and clinical reviews. A utilization nurse completes no less than 20 initial clinical reviews daily. Responsibilities… more
- Alameda Health System (Oakland, CA)
- …background. Required Licenses/Certifications : Valid license to practice as a Registered Nurse in the State of California. Preferred Licenses/Certifications ... of quality improvement initiatives. Oversees the secondary review process; actively appeals denied cases when necessary and assists physicians with appeals… more
- MVP Health Care (Tarrytown, NY)
- …New York Qualifications you'll bring: Current New York State Licensure as a Registered Nurse required. Certification in Case Management required within 24 months ... to maintain cost-effectiveness and manage Medical Loss Ratio (MLR). Appeals & Denials: Participate in the appeals ...(MLR). Appeals & Denials: Participate in the appeals process for denied services and ensure timely resolution.… more
- Elevance Health (Columbus, OH)
- ** Nurse Appeals RN ** **Location** : Ohio-Cincinnati, Columbus, Mason, or Seven Fields _(Must be within commutable distance to the listed locations.)_ ... an accommodation is granted as required by law._ The ** Nurse Appeals ** is responsible for investigating and...would provide an equivalent background. + Current active unrestricted RN license to practice as a health professional within… more
- Elevance Health (Tampa, FL)
- ** Nurse Appeals ** **Hybrid 1:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing ... an accommodation is granted as required by law._ The ** Nurse Appeals ** is responsible for investigating and...would provide an equivalent background. + Current active unrestricted RN license to practice as a health professional within… 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
- CVS Health (Lansing, MI)
- …with heart, each and every day. **Position Summary** CVS Aetna is seeking a dedicated ** Appeals Nurse Consultant** to join our remote team. In this role, you ... a critical role in ensuring fair and accurate resolution of clinical appeals by applying sound clinical judgment and regulatory knowledge. **Key Responsibilities** +… more
- Molina Healthcare (NE)
- …will be supporting our Appeals and Grievances department. We are seeking a Registered Nurse with previous Appeals experience. The candidate must have ... Nurse provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state...or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must… more
- Corewell Health (Grand Rapids, MI)
- …experience clinical nursing and or case management/managed care or related field Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire required ... all components of insurance prior authorizations, initial reviews, continuous stay reviews and appeals . Nurse Care Manager - Plans and prioritizes care for… more
- MD Anderson Cancer Center (Houston, TX)
- …audits of patient accounts to complete Defense Audits. *Ideal Candidate:* A * Registered Nurse ( RN )* with experience in * appeals * and * nurse defense ... years of the five clinical nursing experience. * Preferred: Nurse Defense Audit experience, experience with insurance appeals...remote. Prefer Houston/local area. *LICENSES AND CERTIFICATIONS* * Required: RN - Registered Nurse -… more
- State of Colorado (Grand Junction, CO)
- Registered Nurse I, RN I...of the department's action. For more information about the appeals process, the official appeal form, and how to deliver ... - Grand Mesa Youth Services Center Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5157862) Apply Registered Nurse I, RN I - Grand… more
- University of Washington (Seattle, WA)
- …Medical Center-Montlake - Endocrine Care Center** has an outstanding opportunity for a ** Registered Nurse .** **WORK SCHEDULE** + 40 hours per week + ... - this position will be the only full time RN on the team **PRIMARY JOB RESPONSIBILITIES** + Provide...nursing experience + Active licensure to practice as a Registered Nurse in Washington State + Active… 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
- 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...Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days… 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
- 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
- State of Colorado (Pueblo, CO)
- Nurse I - Registered Nurse ...if your application is eliminated. You will find the appeals process, the official appeal form, and how to deliver ... - 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 (Pueblo, CO)
- Registered Nurse II- CMHHIP Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5130585) Apply Registered Nurse II- CMHHIP Salary ... listed. + Description + Benefits + Questions Department Information Registered Nurse II-Full Time CMHHIP This posting...if your application is eliminated. You will find the appeals process, the official appeal form, and how to… more
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