• Clinical Appeals Nurse (RN)

    Molina Healthcare (Omaha, NE)
    …+ Prepares and presents cases in conjunction with the Chief Medical Officer for Administrative Law Judge pre-hearings, State Insurance Commission, and Meet ... leadership and mentoring for less experienced appeal LVN, RN and administrative staff. **JOB QUALIFICATIONS** **Required Education** Graduate from an Accredited… more
    Molina Healthcare (08/20/25)
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  • Medical Director - Medicare Grievances and Appeals…

    Humana (Lincoln, NE)
    …with review policies, procedures, and performance standards. Represents Humana at Administrative Law Judge hearings. Exercises independent judgment ... and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action. **Schedule is Monday-Friday with… more
    Humana (09/06/25)
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  • Corporate Medical Director - Medicare Grievances…

    Humana (Lincoln, NE)
    …with coverage policies, procedures, and performance standards. CMD represents Humana at Administrative Law Judge hearings; exercises independent clinical ... judgment and decision making on complex issues regarding job duties and related tasks; works under minimal supervision; and assists in supporting the medical director team and leaders in meeting enterprise-wide business needs. **After an initial training… more
    Humana (09/05/25)
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