• Registered Nurse - Clinical

    Cognizant (Harrisburg, PA)
    …have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and utilization management experience with managed ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...related to clinical denial management and managing clinical denials from Providers to the Health… more
    Cognizant (10/09/25)
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  • RN Case Manager (Part Time) - West Penn…

    Highmark Health (Pittsburgh, PA)
    …all regulatory and contractual requirements. + Documents, monitors, intervenes/resolves and reports clinical denials / appeals and retrospective payer audit ... :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Registered nurse who is proficient in the...clinical nursing role + Current State of PA RN licensure OR Current multi-state licensure through the enhanced… more
    Highmark Health (09/13/25)
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  • RN Clinical Review Appeals

    St. Luke's University Health Network (Allentown, PA)
    …we serve, regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical ... Works inside with adequate lighting, comfortable temperature and ventilation. EDUCATION: Registered Nurse required, BSN preferred. Current license required. .… more
    St. Luke's University Health Network (10/28/25)
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  • Clinical Appeals Nurse

    Penn State Health (Hershey, PA)
    …executive orders that prohibit or outlaw discrimination._ **Union:** Non Bargained **Position** Clinical Appeals Nurse - Revenue Integrity Process ... clinical documentation to determine the validity of payer denials . + Draft persuasive appeal letters using clinical...Nursing required. + Currently licensed to practice as a Registered Nurse by state of employment or… more
    Penn State Health (10/24/25)
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