- State of Colorado (Denver, CO)
- …duties. This position works under the supervision and direction of a registered nurse and assists with psychiatric nursing care of mentally ill patients; observes, ... Therapeutic Patient Care: Under the direction and supervision of a registered nurse , engage with patients to establish and maintain a therapeutic relationship which… more
- Mount Sinai Health System (Long Island City, NY)
- …field **Experience Requirements** 5 years of Case Management and 6 years of clinical nurse experience. Previous supervisory experience in Case Management or a ... will direct and manage departmental activities involved in utilization review, appeals management and discharge planning to facilitate the case management process… more
- Molina Healthcare (Ann Arbor, MI)
- …state, and local laws and regulatory requirements affecting the medical and clinical staff. **Job Duties** + Provides medical oversight and expertise in ... medical necessity. + Participates in and maintains the integrity of the appeals process, both internally and externally. Responsible for the investigation of adverse… more
- State of Colorado (Pueblo, CO)
- …CAA P/T 3557 Physician 5/2025 Department Department of Corrections Division Clinical and Correctional Services Opening Date 05/12/2025 Closing Date 9/18/2025 4:00 ... on-call assessment, diagnosis, and treatment of inmates in one or more prison clinical settings. Physicians are responsible for, but not limited to, the following: +… more
- Molina Healthcare (Layton, UT)
- …state, and local laws and regulatory requirements affecting the medical and clinical staff. *Must reside in Idaho **Job Duties** + Provides medical oversight ... medical necessity. + Participates in and maintains the integrity of the appeals process, both internally and externally. Responsible for the investigation of adverse… more
- Sacramento County (Sacramento, CA)
- …Psychologist, Licensed Clinical Social Worker, Marriage Family Therapist, or Registered Nurse . Note: Failure to maintain a required license may be cause for ... Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days...Clinical Social Worker, Marriage Family Therapist, or Registered Nurse . Note: Failure to maintain a required license may… more
- Trinity Health (Livonia, MI)
- …including but not limited to, appending modifiers, and checking clinical documentation. Provides feedback to intra-departmental Revenue Integrity colleagues ... Maintains productivity standards Maintains compliance with regulatory requirements Assist Nurse Auditor and/or Coordinator with denial coordination process; including… more
- Morehouse School Of Medicine (Atlanta, GA)
- …pedagogies. Reporting directly to the Senior Associate Dean and Chief of Clinical & Academic Education, the Chair will collaborate closely with senior leadership ... Holds or is eligible for DEA licensure . Strong clinical background with a minimum of five years full-time...ongoing professional development . Assist faculty in resolving grade appeals and addressing informal and formal complaints Student Success… more
- Sharecare (Boston, MA)
- …available 3rd parties for care management and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and ... enrollment / new hire plan selection, claims issues, ID card issues, grievances/ appeals , utilization management (UM) status, including but not limited to medical,… more
- Centene Corporation (Jefferson City, MO)
- …the auditing of corporate, health plan, and specialty company staff related to clinical systems entry and/or processes + Develop and maintain the audit process and ... tools related to: authorizations, appeals , quality events, and case management in CCMS; interrater...auditing outcomes and system maintenance with the Sr. + Clinical Systems Specialist to resolve or enhance clinical… more