- Molina Healthcare (Lincoln, NE)
- … decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making...these guidelines. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
- Evolent (Lincoln, NE)
- …to Standard processing, documenting accordingly. + Works closely with the appeals -dedicated Clinical Reviewers to ensure timely adjudication of processed ... for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a...and Preferred:** + 1-3 years' experience and as an RN - **Required** + Minimum of 5 years in… more
- Prime Therapeutics (Lincoln, NE)
- …+ 5 years of work experience in case management or professional practice + Current Registered Nurse ( RN ) license in good standing with the Board of ... Consultant leads cross functional committees that review FWA member lock in appeals . **Responsibilities** + Leverage clinical judgement to evaluate members for… more