- CVS Health (Hartford, CT)
- …+ Basic awareness of problem solving and decision making skills Position Summary The Appeals Nurse Consultant position is responsible for processing the ... Position OverviewAdministers review and resolution of clinical complaints and appeals . Interprets data obtained from clinical records to apply...a production role and remains as part of the Nurse Appeal Consultant job code. Primary duties… more
- CVS Health (Hartford, CT)
- …of 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… more
- CVS Health (Hartford, CT)
- …US. Standard 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 are not limited to: Requesting clinical, research, extrapolating pertinent… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Appeals and Grievances Clinical Operations RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 ... safety net required to achieve that purpose. Job Summary The Supervisor of Appeals and Grievances Clinical Operations (A&G) RN is responsible for executing the… more
- Sacramento County (Sacramento, CA)
- Registered Nurse D/CF (Level I/II) Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/454059) Apply Registered Nurse D/CF (Level I/II) ... at 5:00 pm on: 11/6/2023, 1/2/2024, 3/5/2024, 5/7/2024, 7/2/2024, 9/3/2024, 11/5/2024 Registered Nurse D/CF Level I: $59.32 - $72.10 hourly Registered Nurse D/CF… more
- Sacramento County (Sacramento, CA)
- Licensed Vocational Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448956) Apply Licensed Vocational Nurse D/CF Salary ... 4/4/24, 7/5/24, 10/3/24 In a detention/correctional facility, the Licensed Vocational Nurse D/CF performs a wide variety of vocational nursing duties, including… more
- Sacramento County (Sacramento, CA)
- Registered Nurse Level I/II *Revised Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/2579173) Apply Registered Nurse Level I/II *Revised ... Note: Vacancies may be permanent or intermittent on-call. Registered Nurse Level I: $43.76 - $53.19 hourly Registered ...Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days… more
- Banner Health (AZ)
- …you're looking to leverage your abilities - apply today. The Registered Nurse RN Denial Management Specialist is responsible for reviewing concurrent inpatient ... Provides clinical expertise and oversight in the determination of the clinical appeals and denial management process resulting in significant savings for the… more
- American Red Cross (Philadelphia, PA)
- …central venous catheters, and access vortex and bard ports. + Act as a consultant to external health care personnel about clinical apheresis. + The American Red ... WHAT YOU NEED TO SUCCEED (Minimum Qualifications): + Registered Nurse with current state licensure as required. + A...make a difference by volunteering in a position that appeals to you and allows you to use your… more
- American Red Cross (Omaha, NE)
- …and their family and other attending healthcare professionals. + Act as a consultant to external health care personnel about clinical apheresis. + Assess patient ... Qualifications ): + Current state licensure as a Registered Nurse and CPR certification is required . + Bachelor's...make a difference by volunteering in a position that appeals to you and allows you to use your… more
- Highland General Hospital (Oakland, CA)
- …and internal compliance studies. + Oversees the secondary review process; actively appeals denied cases when necessary and assists physicians with appeals . ... and/or techniques. + Review cases regularly with staff; acts as clinical consultant regarding care management issues; guides clinical staff with review of… more
- Highland General Hospital (Oakland, CA)
- …Medicare and internal compliance studies. -Oversees the secondary review process; actively appeals denied cases when necessary and assists physicians with appeals ... equipment and/or techniques. -Reviews cases regularly with staff; acts as clinical consultant regarding care management issues; guides clinical staff with review of… more
- Clark County, NV (Las Vegas, NV)
- …and oversees the work of contract professionals; negotiates and administers consultant contracts. Coordinates and assists in the processing of applications submitted ... retail or mail order fills) + 24/7 Telephone Advice Nurse - no employee cost + Teledoc, Doctoroo, and...applicant's response to each item in the assessment, score appeals will not be allowed for this recruitment. +… more
- Sacramento County (Sacramento, CA)
- …of California to practice as a: Either: 1. Psychiatric Technician Or: 2. Registered Nurse Or: 3. Vocational Nurse Note: The word "experience" referenced in the ... language other than standard English; and/or act as a consultant to others regarding the needs and problems presented...Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days… more
- City and County of San Francisco (San Francisco, CA)
- …of experience as a Licensed Psychiatric Technician or a Licensed Vocational Nurse providing psychiatric nursing care in a skilled facility or psychiatric acute ... permanent or temporary (including an interim permit) California Licensed Vocational Nurse License or Licensed Psychiatric Technician License. Applicants must meet… more
- American Red Cross (Milford, CT)
- …courses in First Aid, CPR/AED, Babysitter's Training, Lifeguard Training, Certified Nurse Aid Training, and other certification courses. American Red Cross Training ... note: If you are contract personnel or an independent consultant to the American Red Cross, you must access...make a difference by volunteering in a position that appeals to you and allows you to use your… more
- Amgen (Indianapolis, IN)
- …Must be able to effectively collaborate across all corporate functions-MSLs, TLLs, Nurse Coordinators, Field Access Team, supporting sales teams, etc. + Key account ... by better understanding the customer's needs + Serves as a resource/ consultant to customers and staff regarding payer policies and processes (eligibility… more
- Stanford Health Care (Palo Alto, CA)
- …Workers, Complex Case Managers Support Liaisons, and Utilization/Denials & Appeals . This individual works collaboratively with managers, directors, content experts ... to care for patients. Serves as an influential leader, role model, and consultant for clinical and educational practices. This individual will consult with managers… more
- Centene Corporation (Trenton, NJ)
- …Develop and maintain the audit process and tools related to: authorizations, appeals , quality events, and case management in CCMS; interrater reliability related to ... and tools + Facilitate compliance with the auditing process + Act as a consultant related to system auditing to others in the unit, department and health plan… more
- American Red Cross (MN)
- …courses in First Aid, CPR/AED, Babysitter's Training, Lifeguard Training, Certified Nurse Aid Training, and other certification courses. American Red Cross Training ... note: If you are contract personnel or an independent consultant to the American Red Cross, you must access...make a difference by volunteering in a position that appeals to you and allows you to use your… more