- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse (RN) Manager , Appeals and Grievances General Operations ( Clinical ) Job Category: Clinical Department: CSC Appeals & Grievances ... the safety net required to achieve that purpose. Job Summary The Manager , Appeals & Grievances (A&G) & General Operations ( Clinical ) is responsible for the… more
- Elevance Health (Atlanta, GA)
- ** Nurse Appeals ** **Hybrid 1:** This role.../grievances/quality of care issues and is a resource for clinical and non clinical team members in ... an accommodation is granted as required by law._ The ** Nurse Appeals ** is responsible for investigating and...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Catholic Health (Buffalo, NY)
- …with varied hours based on role of management and oversight of team Summary: The Clinical Denials and Appeals , Clinical Supervisor is responsible for the ... people, carrying out and documenting the appeals process for denied claims denied due to reasons...denied due to reasons including, but not limited to clinical documentation/support for diagnostic related grouping (DRG) assignment, inpatient… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …license; must maintain licensure throughout employment + Minimum of 5 years' experience in Clinical Appeals and Grievances within a managed care or payor setting ... regulatory guidelines including URAC, NCQA, and ERISA + Proficiency in Clinical Appeals , Utilization Review, and Grievance processes including benefit… more
- Stanford Health Care (Palo Alto, CA)
- …role in the Revenue Cycle Denials Management Department by managing and resolving clinical appeals related to government audits and denials. This position ... in healthcare regulations, payor policies, and industry best practices related to clinical appeals and denials management. Evaluate internal controls related to… more
- State of Colorado (Denver, CO)
- …and level of staffing during own shift and proximal shifts + Collaboration with Nurse Manager and treatment team, recommends a change in program scheduling to ... During specific shifts, functions in the role of Charge Nurse and provides clinical and administrative supervision...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- **Join our team as a Clinical Review Manager \!** We are seeking a quick learner who is self\-motivated and capable of working independently\. The ideal candidate ... retrospective claim review, special review requests, and UM pre\-certifications and appeals , utilizing medical appropriateness criteria, clinical judgement, and… more
- State of Colorado (Pueblo, CO)
- Nurse I CMHHIP Relief Pool - Registered Nurse I - CMHHIP Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5102074) Apply Nurse I CMHHIP ... + Description + Benefits + Questions Department Information Registered Nurse I-Part Time CMHHIP This posting will be used...This position is responsible for assisting nursing staff with clinical direction of nursing staff, QA/PI activities and to… more
- State of Colorado (Pueblo, CO)
- Registered Nurse II- CMHHIP Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5101960) Apply Registered Nurse II- CMHHIP Salary $45.99 - ... and time listed. + Description + Benefits + Questions Department Information Registered Nurse II-Full Time CMHHIP This posting will be used to fill multiple… more
- State of Colorado (Pueblo, CO)
- Nurse I - ECT & Outpatient Coordinator - CMHHIP...as indicated in this announcement and if the hiring manager chooses to extend a job offer to you, the ... Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5094633) Apply Nurse I - ECT & Outpatient Coordinator - CMHHIP...hiring manager may make you a job offer within the… more
Related Job Searches:
Appeals,
Appeals Nurse,
Clinical,
Clinical Appeals Nurse,
Manager,
Nurse,
Nurse Manager