- Cognizant (Sacramento, CA)
- …to be considered** + Educational background - Registered Nurse ( RN ) + 2-3 years combined clinical and/or 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
- 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 ... and grievances to find the root cause of denials . Duties Continued Check, verifies and ensure that all… more
- Sharp HealthCare (La Mesa, CA)
- …**Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered ... care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA...advice to Revenue Cycle/HIM regarding RAC decision to appeal, denials , input into appeals , share findings with… more
- University of Southern California (Arcadia, CA)
- …mix, LOS, cost per case, excess days, resource utilization, readmission rates, denials , and appeals . + Collaborates and communicates with multidisciplinary team ... with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost.... Licenses and Certifications Minimum (Required) * A current RN licensure in the State of California is required.… more
- Sharp HealthCare (San Diego, CA)
- …Master's Degree; Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered ... case management, utilization review, care coordination experience. + California Registered Nurse ( RN ) - CA...advice to Revenue Cycle/HIM regarding RAC decision to appeal, denials , input into appeals , share findings with… more
- Sharp HealthCare (San Diego, CA)
- …Day **FTE** 1 **Shift Start Time** **Shift End Time** Bachelor's Degree in Nursing; California Registered Nurse ( RN ) - CA Board of Registered Nursing; ... or equivalent experience in the healthcare setting. + California Registered Nurse ( RN ) - CA...advice to Revenue Cycle/HIM regarding RAC decision to appeal, denials , input into appeals , share findings with… more
- University of Southern California (Arcadia, CA)
- …requirements impact DRG assignments. + Minimum of three years' experience in clinical disciplines ( RN , MD, FMG) or utilization review/case management in ... recommendations on query structure, process, and workflow. Responds to coding denials with clinical justifications and coding conventions. Maintain… more