- Nuvance Health (Danbury, CT)
- …operational oversight for a team of utilization review staff, denials and appeals specialists, non-clinical support staff while partnering with local case management ... organizational efficiency, and maximized reimbursement through denial reduction and successful appeals . The *System Care Coordination Leader* will be responsible for… more
- Hartford HealthCare (Farmington, CT)
- … appeals preferred. **Licensure, Certification, Registration** * Active Registered Nurse license from the State of Connecticut * Certified Clinical Documentation ... Key responsibilities include timely investigation of DRG downgrades, submitting appeals , coordinating follow-up actions and ensuring compliance with regulatory… more
- Iowa Department of Administrative Services (State Of Iowa, IA)
- …IA Job Type Full-time Job Number 26-01561 Agency 427 Department of Inspections, Appeals & Licensing Opening Date 12/15/2025 Closing Date 3/15/2026 11:59 PM Central ... + Description + Benefits + Questions Job Description Join theDepartment of Inspections, Appeals , and Licensing's Health & Safety Divisionand play a vital role in… more
- Houston Methodist (Sugar Land, TX)
- …utilization review activities, and monitoring the clinical denial management and appeals process, as applicable, in collaboration with clinical team partners. This ... and determines the need for or feasibility of submitting appeals . + Facilitates communication with payors and external case...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -… more
- Clark County, NV (Las Vegas, NV)
- …Pharmacy Benefits (30, 90-day retail or mail order fills) + 24/7 Telephone Advice Nurse - no employee cost + Teledoc, Doctoroo, and Dispatch Health + Retiree ... applicant's response to each item in the assessment, score appeals will not be allowed for this recruitment. +...Experience" sections detailed on my application and that scoring appeals will not be allowed for this recruitment. 11… more
- State of Colorado (Pueblo, CO)
- …occurs, ambulation and feeding; + Obtains and records vital signs for review by staff nurse ; + Provide and assist with patient transfers and turning in bed; + Report ... condition and patient health care complaints to shift registered nurse ; + Empty catheter bags; offer fluids and record...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Canon City, CO)
- …in mind. Preferred Qualifications: + A current, valid license as a Registered Nurse from the Colorado Board of Nursing, or any state participating in the ... Enhanced Nurse Licensure Compact (eNLC). + At least one year...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Denver, CO)
- …QUALIFICATIONS: + Applicant must possess current, valid licensure as an Advanced Practice Nurse / Nurse Practitioner from the Colorado Board of Nursing or ... Applicant must have two years experience as a Registered Nurse , andsix months of gender affirming care experience, which...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Fremont County, CO)
- …by supervising residents' whereabouts, interactions, and conditions and refer to the charge nurse if necessary Hygiene Care + Collaborate with the charge nurse ... appropriateness of the Treatment Care Plan, inform the charge nurse of refusals of hygiene care. + Document observations...if your application is eliminated. You will find the appeals process, the official appeal form, and how to… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …of this position:*The Contract Variance Analyst provides foundational support in managing appeals related to payer contract variances and fatal denials. This role is ... Contract Variance Appeal process by assisting with intake, documentation, and tracking of appeals submitted to third-party payers * Prepares and submits appeals … more