• Clinical Appeals & Denials Manager

    R1 RCM (Chicago, IL)
    …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals and Denials Manager** , you will serve as ... an expert on clinical appeals and denials management. Every day...to optimize the revenue cycle. **Preferred Skills:** + Active RN license For this US-based position, the base pay… more
    R1 RCM (09/13/25)
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  • Clinical Appeals Supervisor

    R1 RCM (Salt Lake City, UT)
    …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals Supervisor** , you will help support clinicians ... position. **Here's what you will experience working as a Clinical Appeals Supervisor:** + Track and monitor...for additional support and engagement. **Required Skills:** + Active Registered Nurse license For this US-based position,… more
    R1 RCM (08/31/25)
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  • Clinical Appeals Nurse

    Centene Corporation (Columbia, SC)
    …analyze and report verbal and written information regarding member and provider clinical appeals , including information follow up + Prepare response letters ... for member and provider clinical appeals and ensure letters are compliant...all policies and standards Must reside in SC **Education/Experience:** RN with 4+ years of clinical nursing… more
    Centene Corporation (09/13/25)
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  • Clinical Appeals Nurse

    Molina Healthcare (Omaha, NE)
    … decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making...these guidelines. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
    Molina Healthcare (08/20/25)
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  • Clinical Appeals Nurse

    R1 RCM (Chicago, IL)
    …platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals Nurse ** , you will help our ... position. **Here's what you will experience working as a Clinical Appeals Nurse :** + Conduct...at telephonic hearings if needed. **Required Skills:** + Active Registered Nurse license For this US-based position,… more
    R1 RCM (09/13/25)
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  • Clinical Appeals Author (E)

    Charter Care Health Partners (Providence, RI)
    Summary: The Clinical Appeals - Author performs appeals and denials management and represents the hospital where claims were denied by either governmental ... administrative duties as required. Education/Licensure: Medical Graduate, Physician Assistant or Registered Nurse (Current RI License) Experience: + Knowledge of… more
    Charter Care Health Partners (09/13/25)
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  • RN Clinical Denials Appeals

    CommonSpirit Health Mountain Region (Centennial, CO)
    …with resources to help you flourish and leaders who care about your success. The RN Clinical Denials Appeals Specialist functions as a revenue management ... will need the following: Required Education: BSN required Minimum Experience required: 4 years clinical experience as a Registered Nurse . 3 years with… more
    CommonSpirit Health Mountain Region (09/10/25)
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  • Registered Nurse ( RN

    LA Care Health Plan (Los Angeles, CA)
    Registered Nurse ( RN ) Manager, Appeals and Grievances General Operations ( Clinical ) Job Category: Clinical Department: CSC Appeals & ... presentations. Excellent verbal, written communication and presentation skills. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and… more
    LA Care Health Plan (09/09/25)
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  • Appeals Nurse Consultant

    CVS Health (Hartford, CT)
    …we do it all with heart, each and every day. **Position Summary** The Appeals Nurse Consultant position is responsible for processing the medical necessity of ... a production role and remains as part of the Nurse Appeal Consultant job code. Primary duties may include,...in a team environment while working remotely. The Medicare Clinical Appeals Team C Member/Non-Par Team operates… more
    CVS Health (09/12/25)
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  • Utilization and Appeals Manager

    Catholic Health Services (Melville, NY)
    …Health was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and appeals ... Responsibilities include but not limited to: Receives, manages and provides clinical reviews and/or submissions as required by contractual or regulatory… more
    Catholic Health Services (07/24/25)
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