• Medical Review & Appeals Director (Hybrid)

    CareFirst (Baltimore, MD)
    …& Qualifications** **PURPOSE:** We are looking for a Director, Medical Review & Appeals for our Government Programs lines of business. The incumbent will ensure ... through direction and oversight of the Clinical Medical Claims Reviews, Clinical Appeals and Analysis programs and Quality of Care complaints in conjunction with… more
    CareFirst (01/06/26)
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  • RN Clinical Review Appeals Specialist…

    St. Luke's University Health Network (Allentown, PA)
    …a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all ... APR-DRG for the purpose of appealing proposed DRG and coding changes by insurance providers or their respective auditors JOB DUTIES AND RESPONSIBILITIES: + Conduct… more
    St. Luke's University Health Network (10/28/25)
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  • Appeals RN - Care Management Full- time…

    Providence (Torrance, CA)
    …responsible for providing overall management and communication of clinically-based appeals between Providence Health and Services, California Region (PH&S) outside ... Qualifications:** + Associate's Degree - Nursing. + California Registered Nurse License upon hire. + 2 years - Direct...certification upon hire. + Experience working with denials and appeals in/for an acute care setting. + Experience in… more
    Providence (01/07/26)
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  • Licensed Practical Nurse III - Cmhhip

    State of Colorado (Pueblo, CO)
    LICENSED PRACTICAL NURSE III - CMHHIP - Pueblo Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5184282) Apply  LICENSED PRACTICAL NURSE III ... Description + Benefits + Questions Department Information Licensed Practical Nurse III - Full Time CMHHIP This position will...if your application is eliminated. You will find the appeals process, the official appeal form, and how to… more
    State of Colorado (01/06/26)
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  • Charge Nurse RN II - CO Mental Health…

    State of Colorado (Denver, CO)
    Charge Nurse RN II - CO Mental Health Hospital in Fort Logan (S. Denver) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5185912) Apply  Charge ... Nurse RN II - CO Mental Health Hospital in...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
    State of Colorado (01/06/26)
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  • Nurse I - Registered Nurse I…

    State of Colorado (Pueblo, CO)
    Nurse I - Registered Nurse I -...if your application is eliminated. You will find the appeals process, the official appeal form, and how to deliver ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5187654) Apply  Nurse I - Registered Nurse I - CMHHIP Salary $43.80 - $61.31 Hourly Location… more
    State of Colorado (01/06/26)
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  • Registered Nurse II- Cmhhip

    State of Colorado (Pueblo, CO)
    Registered Nurse II- CMHHIP Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5187078) Apply  Registered Nurse II- CMHHIP Salary $45.99 - ... + Description + Benefits + Questions Department Information Registered Nurse II-Full Time CMHHIP This posting will be used...if your application is eliminated. You will find the appeals process, the official appeal form, and how to… more
    State of Colorado (01/06/26)
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  • CDOC Registered Nurse ( Nurse I)

    State of Colorado (CO)
    CDOC Registered Nurse ( Nurse I) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5123731) Apply  CDOC Registered Nurse ( Nurse I) ... Monthly Location Statewide, CO Job Type Full Time Job Number CAA Nurse I Statewide 10/2025 Department Department of Corrections Division Clinical and Correctional… more
    State of Colorado (11/11/25)
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  • Nurse Supervisor

    State of Colorado (Denver, CO)
    Nurse Supervisor - Denver Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5180324) Apply  Nurse Supervisor - Denver Salary $8,369.00 - ... Location Denver, CO Job Type Full Time Job Number Nurse III 34377 Den 12/2025 Department Department of Corrections...Short and long term disability coverage; + Paid life insurance ; + 11 paid holidays per year plus vacation… more
    State of Colorado (12/24/25)
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  • Registered Nurse , Health Compliance…

    State of Colorado (Denver, CO)
    Registered Nurse , Health Compliance Inspector Home Care - FAA00601 (HP III RN) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5183355) Apply  ... Registered Nurse , Health Compliance Inspector Home Care - FAA00601 (HP...with optional 401K/457) + Comprehensive medical, dental, and life insurance + Short- and long-term disability coverage + 11… more
    State of Colorado (01/01/26)
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