• RN UM Clinical Appeals Nurse Remote

    Molina Healthcare (Scottsdale, AZ)
    …Office suite/applicable software program(s) proficiency. **Preferred Qualifications** * Certified Clinical Coder (CCC), Certified Medical Audit Specialist ... - 5:00pm Central time Remote position **Essential Job Duties** * Performs clinical/ medical reviews of previously denied cases in which a formal appeals request… more
    Molina Healthcare (11/14/25)
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  • Specialist , Appeals & Grievances

    Molina Healthcare (Phoenix, AZ)
    …Completion of a health care related vocational program in health care (ie, certified coder , billing, or medical assistant). To all current Molina employees: If ... determine appropriate appeals and grievance outcomes. * Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per… more
    Molina Healthcare (11/16/25)
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  • Associate Specialist , Appeals & Grievances

    Molina Healthcare (Scottsdale, AZ)
    …experience. * Completion of a health care related vocational program (ie, certified coder , billing, or medical assistant). To all current Molina employees: If ... according to state, federal and Molina guidelines. * Requests and obtains medical records, notes, and/or detailed bills as appropriate to assist with research.… more
    Molina Healthcare (11/15/25)
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  • Specialist , Appeals & Grievances

    Molina Healthcare (Mesa, AZ)
    …Completion of a health care related vocational program in health care (ie, certified coder , billing, or medical assistant). To all current Molina employees: If ... **Provider No Surprise Act** cases outcomes. . * Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per… more
    Molina Healthcare (11/09/25)
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  • Delegation Oversight Nurse

    Molina Healthcare (AZ)
    …License must be active and unrestricted in state of practice. * Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case ... Manager (CCM), Certified Professional Healthcare Management (CPHM) or Certified Professional in Healthcare Quality (CPHQ). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina… more
    Molina Healthcare (11/16/25)
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  • LVN Delegation Oversight Nurse Remote

    Molina Healthcare (Mesa, AZ)
    …Office suite/applicable software program(s) proficiency. **Preferred Qualifications** + Certified Clinical Coder (CCC), Certified Medical Audit Specialist ... (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM) or Certified Professional in Healthcare Quality (CPHQ). To all current Molina employees: If you are interested in applying for this position, please apply through the… more
    Molina Healthcare (11/13/25)
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  • Nurse Practitioner or Physician Assistant…

    CenterWell (Phoenix, AZ)
    …advanced practice professionals, Pharm D, Care Coach Nurse, MA, Behavioral health specialist , Quality based Coder , Referral Coordinator and more. Our approach ... accordance with standards of care. + Follows level of medical care and quality for patients and monitors care...in a timely manner working with a quality- based coder to optimize coding specificity. + Follows policy and… more
    CenterWell (10/16/25)
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  • Senior Director, Department Administrator

    Banner Health (Tucson, AZ)
    …Certified Healthcare Facility Manager (CHFM); Certified Facility Manager (CFM); Certified Coding Specialist (CCS); Certified Professional Coder (CPC); JD from an ... as part of your Total Rewards package. Banner University Medical Group is our nonprofit faculty practice plan associated...care to patients at highly ranked Banner - University Medical Centers and dozens of clinics while providing mentorship… more
    Banner Health (11/12/25)
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  • Investigator, Coding Special Investigative Unit…

    Molina Healthcare (AZ)
    …to present those findings. **Preferred License, Certification, Association** + AAPC Certified Medical CPC, CPMA, CPCO or similar specialist preferred + Certified ... for investigating and resolving instances of healthcare fraud and abuse by medical providers. This position uses information from a tip, member benefits, and… more
    Molina Healthcare (10/22/25)
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  • Executive Director, Chief Actuary

    Banner Health (Phoenix, AZ)
    …Certified Healthcare Facility Manager (CHFM); Certified Facility Manager (CFM); Certified Coding Specialist (CCS); Certified Professional Coder (CPC); JD from an ... in support of audits of health care liabilities, communicating ROI for medical management and other health plan initiatives to leadership, preparing and delivering… more
    Banner Health (08/23/25)
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