- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- Ready to help us transform healthcare? Bring your true colors to blue. The RoleThe Clinical Appeals Nurse Reviewer is responsible for applying sound ... an integral part of the Appeal Review team, the Clinical Appeals Nurse Reviewer will...to assist with medical necessity determinations. Key Qualifications: + Registered Nurse with an active unrestricted professional… more
- Molina Healthcare (GA)
- … decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical ... **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse who must...with internet connectivity of high speed required **Job Summary** Clinical Appeals is responsible for making appropriate… more
- Centene Corporation (Columbia, SC)
- …analyze and report verbal and written information regarding member and provider clinical appeals , including information follow up + Prepare response letters ... for member and provider clinical appeals and ensure letters are compliant...all policies and standards Must reside in SC **Education/Experience:** RN with 4+ years of clinical nursing… more
- LifePoint Health (Hickory, NC)
- * Registered Nurse ( RN ), Clinical Case Manager* PRN * * *Your experience matters* At Frye Regional Medical Center, we are driven by a profound commitment ... prohibiting discrimination and harassment in employment." **Job:** **Nursing* **Organization:** ** **Title:** * Registered Nurse ( RN ), Clinical Case… more
- State of Colorado (Denver, CO)
- …(HP III RN ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5019261) Apply Registered Nurse Health Compliance Inspector Home Care - ... Registered Nurse Health Compliance Inspector Home Care -...FAA00094 (HP III RN ) Salary $80,916.00 Annually Location Denver, CO Job Type Full Time… more
- State of Colorado (Golden, CO)
- Registered Nurse I, RN I - Campus at Lookout Mountain, Youth Services Center - Golden Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5019028) Apply Registered Nurse I, RN I - Campus at Lookout Mountain, Youth Services Center… more
- Rochester Regional Health (Rochester, NY)
- …LICENSES / CERTIFICATIONS: BLS - Basic Life Support - American Heart Association (AHA), RN - Registered Nurse - New York State Education Department ... Job Title: Registered Nurse IDepartment: Utilization Management Location:...UM review findings, initiate and 1st, 2nd, and/or arbitration appeals as needed. Document in all areas that an… more
- Guidehouse (New York, NY)
- **Job Family** **:** Clinical Appeals Nurse **Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** + Performs chart ... of care or observation services based on physician certification + Gathers clinical information to conduct continued stay utilization review activities with payers… more
- State of Colorado (CO)
- CDOC Registered Nurse ( Nurse I) Print...RN license. 07 Do you possess an active RN license issued by an Enhanced Nurse Licensure ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4963973) Apply CDOC Registered Nurse ( Nurse I) Salary $7,591.00 - $10,627.00 Monthly… more
- State of Colorado (Sterling, CO)
- CDOC Registered Nurse - Part-time - Sterling Print...Yes + No 06 Do you possess an active RN license issued by an Enhanced Nurse Licensure ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4992041) Apply CDOC Registered Nurse - Part-time - Sterling Salary...Colorado? If so, what state issued your license? 07 Nurse Licensure Compact: If appointed to an RN… more