- Henry Ford Health System (Troy, MI)
- …Windows and Microsoft Word. Excel and Access preferred. CERTIFICATIONS/LICENSURES REQUIRED: + Registered Nurse ( RN ) with current Michigan licensure. ... RN PROVIDER APPEALS COORDINATOR - MEDICAL APPEALS - 40... Nurse ! We are a team of Registered Nurses (3 and counting) and Utilization Review … more
- Centene Corporation (Oklahoma City, OK)
- …Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + RN - Registered Nurse - State Licensure ... option of 4X10's or 5X8 hour shifts Must have RN Compact license **Position Purpose:** Performs clinical ...analyzing the basis for the appeal + Ensures timely review , processing, and response to appeal in accordance with… more
- Veterans Affairs, Veterans Health Administration (Jacksonville, NC)
- …patient information. Completed work should need only a general review by a registered nurse ( RN ) or physician (MD/DO) for appropriateness and conformity ... setting(s). Duties are performed under the supervision of a Registered Nurse ( RN ) or other...medical facilities. HCP include all VA licensed and unlicensed, clinical and administrative, remote and onsite, paid… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …to ensure optimal and cost-effective health outcomes. Required Skills and Experiences * Registered nurse with current MN license and with no restrictions. All ... RN Specialist Complex Case Manager - Oncology Location: Remote Career Area: Health Services About Blue Cross and...of care that leads to optimal, cost-effective outcomes. Leveraging clinical expertise, strong critical thinking skills and a keen… more
- Centene Corporation (Olympia, WA)
- …**License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + RN - Registered Nurse - State Licensure required Pay Range: ... the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified,… more
- Ochsner Health (Lafayette, LA)
- …**Work Experience** Required - 2 years of nursing experience. **Certifications** Required - Current registered nurse ( RN ) license in state of practice. Basic ... are achieved in collaboration with the multi-disciplinary team. **Education** Required - Registered nurse diploma. Preferred - Associate or bachelor's degree in… more
- Veterans Affairs, Veterans Health Administration (Boston, MA)
- …other appointments. Telephone and video care are encouraged. Each physician is assigned a registered nurse , clinical associate, and scheduler. There is no ... VHA Education Loan Repayment Services program office after complete review of the EDRP application. Contact VHA EDRP Program...medical facilities. HCP include all VA licensed and unlicensed, clinical and administrative, remote and onsite, paid… more
- ChenMed (Philadelphia, PA)
- …with bachelor's degree in a related clinical field preferred + A valid, active Registered Nurse ( RN ) license in State of employment required + Compact ... on-site at an assigned hospital daily from 9am-3pm, working remote for the remaining hours. The Acute Care Manager,...the remaining hours. The Acute Care Manager, Complex Care ( RN ) is responsible for achieving positive patient outcomes, managing… more
- PruittHealth (Atlanta, GA)
- …with long-term care population **MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:** * Licensed Registered Nurse with current, unrestricted license in state of ... for each patient based on a thorough history and clinical record review , including the attending physician's...care and regulatory compliance within the company's standards and RN scope of practice. * Comply with PruittHealth Premier's… more
- Humana (Olympia, WA)
- …an impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to...have Compact License** + Greater than one year of clinical experience in a RN role in… more