- HCA Healthcare (Salem, VA)
- …Do you want to join an organization that invests in you as a Clinical Nurse Reviewer? At Parallon, you come first. HCA Healthcare has committed up to $300 million ... a difference. We are looking for a dedicated Clinical Nurse Reviewer like you to be a part of...+ A minimum of one-year experience with denials and appeals in a clinical setting preferred + A minimum… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- **12/2/2025 - REVISED FTE *_SUMMARY:_* We are currently seeking a*Staff Nurse *to join our Utilization Management department for the/Emergency Department / This ... Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for evaluating the medical necessity, appropriateness,… more
- Omaha Children's Hospital (Omaha, NE)
- …Children's Nebraska has an exciting opportunity to join our **Neonatal Nurse Practitioner** **Transport** team! Our NNPs work collaboratively with flight nurses ... of Nebraska offers a unique opportunity for a Neonatal Nurse Practitioner (NNP) to join our dedicated neonatal transport...activities and is home to a world-class zoo that appeals to children and adults alike. Greater Omaha has… more
- City and County of San Francisco (San Francisco, CA)
- …+ Administers nursing care to patients according to physician's and Registered Nurse 's instructions and approved nursing and departmental policies and procedures; as ... by nursing service policy. + The 2312 Licensed Vocational Nurse may perform other duties as assigned/required + LICENSE:...may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department… more
- City and County of San Francisco (San Francisco, CA)
- …Possession of a valid permanent/temporary (including interim permit) California Registered Nurse License ⚠️IMPORTANT: License status must be "Current" according to ... one (1) year of experience working as a Registered Nurse . One-year fulltime employment is equivalent to 2,000 hours...may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department… more
- Cedars-Sinai (CA)
- …Investigates, processes and assists with the resolution of provider grievances and appeals in accordance with contractual requirements and corporate policy. + Begins ... are transitioning to the Skilled Nursing Facilities, refers to nurse practitioner and case manager assigned to the SNF's...employment. **Req ID** : 13443 **Working Title** : Registered Nurse Care Coordinator- Inpatient Specialty Program - 8 Hour… more
- Actalent (Rancho Cordova, CA)
- Utilization Review Nurse About the Role We're looking for a Utilization Review (UR) Nurse to join our team and support high‑quality, cost‑effective patient care ... additional clinical information when needed + Support denial management, including appeals and peer‑to‑peer review processes + Ensure regulatory compliance with… more
- Molina Healthcare (Madison, WI)
- …and recommends corrective actions. * Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. * Attends ... chief medical officer. * Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review and manages the denial… more
- Sanford Health (Rapid City, SD)
- …interaction with payers. Additional duties include management of medical denials, appeals , and grievances. Understand and provide insight into evaluating current ... Experience in medical necessity review preferred. Currently holds an unencumbered registered nurse (RN) license with the State Board of Nursing and/or possess… more
- University of Washington (Seattle, WA)
- …- Endocrine Care Center** has an outstanding opportunity for a **Registered Nurse .** **WORK SCHEDULE** + 40 hours per week + Monday-Friday, 8:30am-5:00pm + ... their caregivers + Manage prescriptions and assist with insurance appeals for specialty medications + Handle the care coordination...experience + Active licensure to practice as a Registered Nurse in Washington State + Active BLS + IV… more