• Clinical Review Clinician - Appeals

    Centene Corporation (Austin, TX)
    …of all appeals requests + Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry ... **RN Strongly Preferred - Compact RN License Required** **100% Remote ** **Business Hours are 8a - 6p CST. Shifts...CST. Shifts include one weekend day** **Position Purpose:** Performs clinical reviews needed to resolve and process appeals more
    Centene Corporation (01/09/26)
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  • Medical Review Nurse (RN)- Remote

    Molina Healthcare (Houston, TX)
    …a clinical resource for utilization management, CMOs, physicians and member/provider inquiries/ appeals . + Provides training and support to clinical peers. + ... JOB DESCRIPTION **Job Summary** Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal… more
    Molina Healthcare (01/09/26)
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  • Care Review Clinician (RN)

    Molina Healthcare (TX)
    For this position we are seeking a (RN) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity of ... (Team will work on set schedule) Looking for a RN with experience with appeals , claims review, and medical coding. JOB DESCRIPTION Job SummaryProvides support for … more
    Molina Healthcare (12/24/25)
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