- Stanford Health Care (Palo Alto, CA)
- …180 Days or + CCDS - Cert Clinical Document Spec required within 180 Days + RN - Registered Nurse - State Licensure And/Or Compact State Licensure preferred ... Appeal Specialist II plays a critical role in the Revenue Cycle Denials Management Department by managing and resolving clinical appeals related to government… more
- Cognizant (Sacramento, CA)
- …expectations. **What you need to have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...by performing advanced level work related to clinical denial management and managing clinical denials from Providers… more
- Datavant (Sacramento, CA)
- …Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal writing for inpatient admission. ... by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal writing… more
- Sutter Health (San Francisco, CA)
- …in nursing, case management or related field preferred. **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California + CCM - Certified Case Manager ... Pacific Med Center Van Ness **Position Overview:** Coordinates the utilization management , resource management , discharge planning, post-acute care referrals and… more
- Sharp HealthCare (La Mesa, CA)
- …3 Years Recent acute care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA Board of Registered Nursing ... Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA...and case management software (eg, Allscripts Care Management ).The RN CM will develop and document… more
- Providence (Torrance, CA)
- …them. **Required Qualifications:** + Associate's Degree Nursing. + Upon hire: California Registered Nurse License. + 2 years Direct patient care experience ... **Description** **Appeals RN - Care Manager Remote. This position is...Nursing. Or Master's Degree Nursing. + Upon hire: Case management certification. + Experience working with denials … more
- LA Care Health Plan (Los Angeles, CA)
- …the ability to manage multiple training initiatives simultaneously. Licenses/Certifications Required Licensed Registered Nurse ( RN ) - Active, current and ... Lead Customer Solution Center Appeals and Grievances RN Job Category: Clinical Department: CSC Appeals &...position will mentor, coach, and may provide feedback to management on performance of staff. Ensure team effectiveness and… more
- Genesis Healthcare (Los Angeles, CA)
- …impact in the communities we serve. Responsibilities The Manager, Case Management is responsible for the clinical, administrative, and financial oversight of ... the territory's center-based care management staff. This position oversees the personnel and processes...for effectively addressing concurrent and retrospective clinical and administrative denials by payors and trains staff on same. 5.… more
- University of Southern California (Arcadia, CA)
- …accurate information to payers. The role integrates and coordinates utilization management , care facilitation, and discharge planning functions. The Case Coordinator ... of pre-certification and payer authorization processes, facilitation of the collaborative management of patient care across the continuum, intervening as necessary… more
- Sharp HealthCare (San Diego, CA)
- …**Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered ... case management experience or equivalent experience in the healthcare setting. + California Registered Nurse ( RN ) - CA Board of Registered Nursing… more