• Registered Nurse - Clinical

    Cognizant (Columbus, OH)
    …cycle or clinic operations . Experience in utilization management to include Clinical Appeals and Grievances, precertification, initial and concurrent reviews . ... Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...stand out** . Epic experience . Experience in drafting appeals disputing inpatient clinical validations audits is… more
    Cognizant (10/09/25)
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  • Utilization Management Appeals Nurse

    CVS Health (Columbus, OH)
    …Management (UM) Nurse to join our remote team. **Position Summary** The Appeals Nurse Consultant plays a key role in resolving clinical complaints ... appeals by reviewing medical records and applying clinical guidelines for Utilization Management group. This RN must...clinical resolutions with internal and external support areas. ** Remote Work Expectations** + This is a 100% … more
    CVS Health (10/12/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Akron, OH)
    …resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training and support to clinical ... that has a current active unrestricted license This a remote role and can sit anywhere within the United...set schedule) Looking for a RN with experience with appeals , claims review, and medical coding. **Job Summary** Utilizing… more
    Molina Healthcare (09/06/25)
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