• MVP Health Care (Schenectady, NY)
    …thinking and continuous improvement. To achieve this, we're looking for a Professional, Sub-Acute RN UM Reviewer - Medicare to join #TeamMVP. If you have a ... passion for patient-centered advocacy, clinical precision and regulatory compliance this is an opportunity...skills. Experience with electronic medical record (EMR) systems and UM platforms. Familiarity with CMS regulations and appeals more
    Appcast IO CPA (09/30/25)
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  • RN UM Clinical Appeals

    Molina Healthcare (Albany, NY)
    **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal appeals clinical processes - ensuring that ... to provide quality and cost-effective member care. Candidates with UM and Appeals experience are highly preferred...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/14/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Albany, NY)
    For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... (Team will work on set schedule) Looking for a RN with experience with appeals , claims review,...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/23/25)
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