- Centene Corporation (New York, NY)
- …**License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + RN - Registered Nurse - State Licensure preferred Pay Range: ... determine medical necessity of service preferred. Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred.… more
- Stanford Health Care (Palo Alto, CA)
- …. + CCDS - Cert Clinical Document Spec . + CCDS-O or CDIP . + Nursing\ RN - Registered Nurse - State Licensure And/Or Compact State Licensure preferred ... Abilities** + Expertise in coding and CDI practices., maintaining expertise in Medicare/ Medicaid rules and regulations, as well as current trends and developments. +… more
- Henry Ford Health System (Detroit, MI)
- …ability to successfully advocate for patients and their families. CERTIFICATIONS/LICENSURES REQUIRED: + Registered Nurse ( RN ) + Licensed Social Worker (LMSW) ... service guidelines, clinical practice guidelines, behavior change theory, Medicare and Medicaid regulations and case management principles. + Knowledge of medical… more
- Elevance Health (Indianapolis, IN)
- …or BS in Nursing preferred. + 3 years of clinical experience as a Registered Nurse is strongly preferred. + Experience reviewing medical records, investigation, ... ** Nurse Appeals** **Location: Indiana** **Virtual:** This role enables...would provide an equivalent background. + Current active unrestricted RN license to practice as a health professional within… more
- Tufts Medicine (Boston, MA)
- …**Minimum Qualifications** **:** 1. Bachelor's degree in Pharmacy or Nursing. 2. Licensed Pharmacist, Registered Nurse ( RN ), or Licensed Practical Nurse ... Excel, PowerPoint). 8. Payor knowledge, along with the ability to navigate Medicare, Medicaid and commercial insurance plans to assist with the intake benefit and… more
- Humana (Madison, WI)
- …each day between 6AM and 9AM in their home time zone. **Required Qualifications** + Active Registered Nurse ( RN ) license in the state they reside. + Minimum ... part of our caring community and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record… more
- CareFirst (Baltimore, MD)
- …in addition to the required work experience. **Licenses/Certifications Upon Hire Required:** + RN - Registered Nurse - State Licensure And/or Compact ... Qualifications:** + Significant experience with Government programs including Maryland Medicaid , Medicare Advantage and DSNP. **Knowledge, Skills and Abilities… more
- Accura Healthcare (West Des Moines, IA)
- …of training, education, and effective clinical practices. QUALIFICATIONS: + Hold current Registered Nurse ( RN ) license with applicable state, without ... experience in Long Term Care (LTC). + Knowledge of Medicare and Medicaid rules and regulations. + Strong skills in the following areas: business… more
- Accura Healthcare (Franklin, NE)
- …of training, education, and effective clinical practices. QUALIFICATIONS: + Hold current Registered Nurse ( RN ) license with applicable state, without ... experience in Long Term Care (LTC). + Knowledge of Medicare and Medicaid rules and regulations. + Strong skills in the following areas: business… more
- Elderwood (North Creek, NY)
- …Practical Nurse ): + Credentials as a Licensed Practical Nurse (LPN) or Registered Nurse ( RN ) with a current state license required. + LPN Training ... more! Are you a compassionate and skilled Licensed Practical Nurse (LPN) looking for a fulfilling career? Elderwood at...a 4-star rating from the Centers for Medicare and Medicaid Services (CMS)-exceeding both the New York state average… more