- Centers Plan for Healthy Living (Margate, FL)
- RN - Grievance and Appeals Clinical Reviewer 5297 W Copans Rd, Margate, FL 33063, USA Req #461 Monday, April 29, 2024 Centers Plan for Healthy Living's ... plans they need for healthy living. JOB SUMMARY: The Grievance & Appeal Clinical Reviewer performs complex...in writing. + Analyze and complete written summaries on clinical cases. EDUCATION AND EXPERIENCE: Education: RN … more
- LA Care Health Plan (Los Angeles, CA)
- …The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist Registered Nurse ( RN ) II provides direct assistance to member's with ... Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC...participating provider groups, and other external agencies. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- Elevance Health (Costa Mesa, CA)
- ** Nurse Appeals - Licensed Nurse ** **Location:** *The ideal candidate must reside in the state of California and live within 50 miles of our Woodland Hills ... our PulsePoint locations. **Shift:** Monday to Friday from 8:00-5:00 pm PT The ** Nurse Appeals ** is responsible for investigating and processing and medical… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …Utilization Management services to its clients. The Utilization Review Appeals Nurse performs daily appeal reviews and clinical quality oversite. This ... and Complex Care Needs. Essential Qualifications + Current licensed Registered Nurse ( RN ) with state...within managed care setting. + 3+ years' experience in clinical nurse setting preferred. + Grievance… more
- Elevance Health (Costa Mesa, 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
- The Cigna Group (Bloomfield, CT)
- …, administrative and regulatory criteria for reviewing and making decisions on all non- clinical appeals and validating the accuracy of all received information + ... **Cigna Healthcare Medicare Appeals Reviewer:** We will depend on you to...Additional duties as assigned. **Qualifications** + Education: Licensed Practical Nurse or Registered Nurse +… more
- State of Colorado (Pueblo, CO)
- …statement. 04 Do you possess a valid, active license from the State of Colorado as a Registered Nurse or Nurse Practitioner? + Yes + No 05 Enter your ... This position provides operational and supervisory oversight of multi-disciplinary clinical services staff working at the San Carlos Correctional...Colorado Registered Nurse or Nurse Practitioner… more