- St. Luke's University Health Network (Allentown, PA)
- …Works inside with adequate lighting, comfortable temperature and ventilation. EDUCATION: Registered Nurse required, BSN preferred. Current license required. . ... of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding… more
- Cedars-Sinai (CA)
- …as a condition of continued employment. **Req ID** : 13443 **Working Title** : Registered Nurse Care Coordinator- Inpatient Specialty Program - 8 Hour Days $5K ... Investigates, processes and assists with the resolution of provider grievances and appeals in accordance with contractual requirements and corporate policy. + Begins… more
- City and County of San Francisco (San Francisco, CA)
- …License: Possession of a valid permanent/temporary (including interim permit) California Registered Nurse License ⚠️IMPORTANT: License status must be "Current" ... least one (1) year of experience working as a Registered Nurse . One-year fulltime employment is equivalent...may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department… more
- Crouse Hospital (Syracuse, NY)
- …requirements and contractual agreements. Care Coordination Manager Requirements: + Licensed as a Registered Nurse in New York State + Bachelor's degree + Five ... Coordination Manager who is responsible for providing day to day management of the RN Care Managers in the department. Pay Range: $95,000 plus based on education and… more
- St. Luke's Health System (Boise, ID)
- …exceptional, patient-centered care. **_We are currently hiring for a Full-Time (1.0 FTE) Registered Nurse with at the Children's Endocrinology Clinic located in ... **Overview** At St. Luke's, our dedicated team of ** Registered Nurses** are critical in providing exceptional, patient-centered...**What You Can Expect:** As a Children's Endocrinology Clinic RN , you will play a key role in supporting… more
- Nuvance Health (Danbury, CT)
- *Description* *Summary:* The purpose of the Denial Prevention Nurse is to ensure that all patient admissions are appropriately status within the first 12-24 hours ... notice of conversion, etc. * Tracking and trending all appeals and communicating on a daily/regular basis with the...* Minimum of 2-3 years experience as Utilization Management Nurse in an acute care setting required, minimum of… more
- BronxCare Health System (Bronx, NY)
- …response by the department physician advisors and clinical staff. Qualifications - NYS Registered Nurse required - The Appeal Manager must have excellent verbal ... Overview The Appeals Manager is responsible to assist in the...electronic database system. -The Appeal Manager should be a nurse who has 3-5 years or more of experience… more
- CareFirst (Baltimore, MD)
- …experience is required in addition to the required work experience. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or Compact ... goals resulting in the full and fair review of appeals and designed to achieve corporate objectives and advance...Manager Upon Hire Preferred or + LNCC - Legal Nurse Consultant Certified Upon Hire Preferred **Experience:** + 5… more
- CareFirst (Baltimore, MD)
- …in addition to the required work experience. **Licenses/Certifications Upon Hire Required:** + RN - Registered Nurse - State Licensure And/or Compact ... We are looking for a Director, Medical Review & Appeals for our Government Programs lines of business. The...and oversight of the Clinical Medical Claims Reviews, Clinical Appeals and Analysis programs and Quality of Care complaints… more
- BronxCare Health System (Bronx, NY)
- …special projects and committees as determined by Director. Qualifications CERTIFICATION/LICENSURE : Registered Nurse or physician or a foreign medical graduate ... the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute care services provided to… more