- Commonwealth Care Alliance (Boston, MA)
- …intensive care management and care delivery. Within the CIC Program, the Registered Nurse (RN) serves as an integral member of an interdisciplinary team for medical ... needs of the defined panel of members, the Registered Nurse will engage in regular assessments, visits at regularly...as approved + Supports escalation of member grievances and appeals + Supports the procurement of network providers and… more
- University of Washington (Seattle, WA)
- …and treatment in the phototherapy unit + Assist with prior authorizations and insurance appeals for specialty medications **REQUIREMENTS** + 2 years of current ... Dermatology Clinic** has an outstanding opportunity for a **Registered Nurse .** **WORK SCHEDULE** + Full time / 100% FTE...experience + Active licensure to work as a Registered Nurse in Washington State + Active BLS **ABOUT UW… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …the use of medical and health care services for members. The SN CHA Nurse may also perform other technical and administrative tasks essential to the efficient ... not limited to UM and CM, Fair Hearings and Appeals /Grievances, within three months of working in position. +...package may include participation in group health and/or dental insurance , retirement plan, wellness program, paid time away from… more
- Beth Israel Lahey Health (Plymouth, MA)
- …team to assess and improve the denial management, documentation, and appeals process. + Collaborates with UR Manager and/or physician advisor regarding ... pleasant, professional and cooperative demeanor with patients, physicians, colleagues and insurance companies + Knowledge of government and insurance company… more
- Beth Israel Lahey Health (Plymouth, MA)
- …team to assess and improve the denial management, documentation, and appeals process. + Collaborates with UR Manager and/or physician advisor regarding ... pleasant, professional and cooperative demeanor with patients, physicians, colleagues and insurance companies + Knowledge of government and insurance company… more
- Stanford Health Care (Palo Alto, CA)
- …the Revenue Cycle Denials Management Department by managing and resolving clinical appeals related to government audits and denials. This position requires strong ... analytical and communication skills. The Clinical Government Audit Analyst and Appeals Specialist II will collaborate with clinical staff, coding professionals, and… 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
- Iowa Department of Administrative Services (State Of Iowa, IA)
- …IA Job Type Full-time Job Number 26-00884 Agency 427 Department of Inspections, Appeals & Licensing Opening Date 10/02/2025 Closing Date 10/12/2025 11:59 PM Central ... achievement with a sense of purpose? The Iowa Department of Inspections, Appeals , and Licensing (DIAL) is seeking a highly motivated, flexible, and enthusiastic… 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 ... insurance - eligible after 5 years of service +...applicant's response to each item in the assessment, score appeals will not be allowed for this recruitment. +… more
- State of Colorado (Pueblo, CO)
- …Position: This position works under the supervision and direction of a registered nurse and assists with psychiatric and medical nursing care of mentally ill ... Clinical Skills: + Under the supervision of a registered nurse , interact with patients to build and sustain a...of the department's action. For more information about the appeals process, the official appeal form, and how to… more