- Molina Healthcare (Des Moines, IA)
- … 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 (Des Moines, IA)
- …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
- Trinity Health (Des Moines, IA)
- …health administration or related field required. + Iowa licensure as a Registered Nurse . + Member of a professional healthcare organization.Demonstrated ... Type:** Full time **Shift:** Day Shift **Description:** The purpose of the Clinical Integration Specialist is to assist and support the Director in quality… more
- WesleyLife (Urbandale, IA)
- …& Certifications** **Required** + Occupational Therapist + Physical Therapist + Registered Nurse **Experience** **Required** + 1 year: Full-time experience ... joy in their daily work. Whether you're in a clinical , hospitality, or administrative role, WesleyLife offers opportunities to...regular chart audits. + Manages ADR reviews, insurance denial appeals , interim orders, and 485s. + **Client and Team… more