- CHRISTUS Health (Alamogordo, NM)
- …Medicare Conditions of Participation, DNV standards, HIPAA, and reporting requirements. Submits appeals in a timely manner, upon request by the Director. Initiates ... and reporting individual cases and/or trends to the infection control nurse . Performs utilization management functions as required by payer source. Complies… more
- Elevance Health (Woodland Hills, CA)
- ** Nurse Appeals - Licensed Nurse ** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live in the state of ... **Shift:** Tuesday to Saturday from 8:00-5:00 pm PT The ** Nurse Appeals ** is responsible for investigating and...which would provide an equivalent background. Current active unrestricted RN license to practice as a health professional within… more
- Elevance Health (Woodland Hills, CA)
- ** Nurse Appeals - California candidates only** **Location: This is a virtual position and prefer candidates reside within 50 miles of an Elevance Health ... make an impact:** Responsible for investigating and processing and medical necessity appeals requests from members and providers. **Primary duties may include, but… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …(SNF/LTAC/ARU), Outpatient, DME, and Complex Care Needs. Essential Qualifications + Current licensed Registered Nurse ( RN ) with state licensure. Must retain ... provides Utilization Management services to its clients. The Utilization Review Appeals Nurse performs daily appeal reviews and clinical quality oversite. This… more
- Kepro (Indianapolis, IN)
- …health solutions in the public sector. Acentra is currently looking for a Utilization Management Appeals Nurse - LPN/ RN to join our growing team. Job ... Summary: Our Utilization Management Appeals Nurse - LPN/ RN will...applicable to the position assignment. Required Qualifications/Experience: + Active Registered Nurse ( RN ) or Licensed… more
- CVS Health (Hartford, CT)
- …position are Monday-Friday 8a-5p in time zone of residence. Position Summary The Appeals Nurse Consultant position is responsible for processing the medical ... a production role and remains as part of the Nurse Appeal Consultant job code. Primary duties may include,...experience + Utilization Review experience + Medicare experience + Appeals experience Education + Associate RN Degree… more
- CVS Health (Hartford, CT)
- …or 9-6 in designated time zone) with occasional weekends and holidays. The Appeals Nurse Consultant position is responsible for processing the medical necessity ... a production role and remains as part of the Nurse Appeal Consultant job code. Primary duties may include,...Utilization Review experience + Medicare experience + Managed Care Appeals experience Education + Associate's degree or RN… more
- R1 RCM (Boise, ID)
- …analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Coding Appeals Nurse ** , you will help review and interpret medical ... what you will experience working as a Clinical Coding Appeals Nurse :** + Review and interpret medical...external compliance deadlines are met. **Required Skills:** + Active Registered Nurse license + Active AHIMA or… more
- CVS Health (Hartford, CT)
- …residence with occasional rotational weekend and holiday coverage. Position Summary The Appeals Nurse Consultant position is responsible for processing the ... medical necessity of Medicare Part C appeals from both members and providers. This role is...a production role and remains as part of the Nurse Appeal Consultant job code. Primary duties may include,… more
- CVS Health (Hartford, CT)
- …business hours 8a-5p in time zone of residence Monday - Friday. The Appeals Nurse Consultant position is responsible for processing the medical necessity ... of Medicare appeals for participating providers. Primary duties may include, but...3+ years of clinical experience required Active and unrestricted RN licensure in state of residence Preferred Qualifications Managed… more
- Universal Health Services (Richmond, VA)
- …CBO is seeking a dynamic and talented Clinical Documentation Improvement (CDI) Nurse . The Clinical Documentation Improvement (CDI) Nurse provides clinically ... Qualifications Education, Training, Experience and Licenses/Registrations Required: + Current RN license and maintained during employment in this position +… more
- Trinity Health (Saratoga Springs, NY)
- …this creates work life balance. I absolutely love my job!" Teresa A. ** Registered ** ** Nurse ( RN )-Hospice Case Manager - HOMECARE** **-Saratoga&Washington ... exactly how I feel since becoming a Community Hospice RN . Caring for our patients is a rewarding life...need:** + A current license to practice as a Registered Nurse in the State of New… more
- Walgreens (Deerfield, IL)
- …"An Equal Opportunity Employer, including disability/veterans". **Job ID:** 1405241BR **Title:** Registered Nurse ( RN ) Specialty - Remote **Company ... to defined medications. Evaluates all requests for prior authorizations, appeals and accompanying tasks. + Provides nursing network subject...Associate's degree in Nursing + Current license/registration as an RN ( Registered Nurse ) with the… 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/4394165) Apply CDOC Registered Nurse ( Nurse I) Salary $7,225.00 Monthly Location Statewide,… more
- American Red Cross (NJ)
- …is represented by union contract. WHAT YOU NEED TO SUCCEED (Minimum Qualifications) : + Registered nurse license required ( RN ) + Minimum one year of ... step of the blood collection process. As a charge nurse you will lead a team, draw blood and,...make a difference by volunteering in a position that appeals to you and allows you to use your… more
- Ascension Health (Minooka, IL)
- …management rules and regulations. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Illinois Board of Nursing ... related to coding, medical records/documentation, precertification, reimbursement, and claim denials/ appeals . + Assess and coordinate discharge planning needs with… more
- Sacramento County (Sacramento, CA)
- Supervising Registered Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448883) Apply Supervising Registered Nurse ... are at 5:00 pm on: 2/5/24, 4/2/24, 6/3/24, 8/5/24, 10/7/24, 12/2/24 Supervising Registered Nurse - Detention/Correctional Facility is the first level supervisory… 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)
- …understood the above special requirements. 04 Select the one box that best describes your Registered Nurse ( RN ) license issued by the State of California. + ... Registered Nurse Level I/II Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/2579173)...Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days… more
- Intermountain Health (Billings, MT)
- **Job Description:** The Registered Nurse ( RN ) is a professional caregiver who assumes responsibility and accountability for assessing, planning, ... implementing and evaluating care of patients. The staff RN utilizes the nursing process by use of technology,...offer a sign-on bonus and/or relocation assistance when applicable.** ** Registered Nurse Scope Of Practice:** As a… more
