- Houston Methodist (Sugar Land, TX)
- …care for government and nongovernmental payers preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- ... At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical… more
- UNC Health Care (Kinston, NC)
- …preferred. + **EXPERIENCE** + Minimum 3-5 years of applied clinical experience as a Registered Nurse required. + 2 years utilization review, care management , ... or compliance experience preferred. + Minimum 1 year clinical denials management preferred. + **LICENSURE/REGISTRATION/CERTIFICATION** + Licensed to practice as… more
- Nuvance Health (Danbury, CT)
- …and trending all appeals and communicating on a daily/regular basis with the Denials Management team. * Assists with informing Managed Care contracting team ... This role plays a critical part in preventing payment denials by providing timely and accurate clinical information to...required * Minimum of 2-3 years experience as Utilization Management Nurse in an acute care setting… more
- Stanford Health Care (Palo Alto, CA)
- …180 Days or + CCDS - Cert Clinical Document Spec required within 180 Days + RN - Registered Nurse - State Licensure And/Or Compact State Licensure preferred ... Appeal Specialist II plays a critical role in the Revenue Cycle Denials Management Department by managing and resolving clinical appeals related to government… more
- McLaren Health Care (Grand Blanc, MI)
- …including role, responsibilities tools, and methodologies. _Required:_ + State licensure as a Registered Nurse ( RN ) + Bachelor's degree in nursing from ... Summary** : Responsible for assisting the Corporate Director of Denials Management in the coordination of day-to-day...or utilization review experience + Five years of clinical nurse experience in an acute care setting + American… more
- Nuvance Health (Danbury, CT)
- …in nursing, health administration, or a related field preferred * Current licensure as a registered nurse ( RN ) * Minimum of 5 years of clinical experience ... and strategy for system-wide care coordination, encompassing utilization review (UR), denials management , discharge planning, social work, and non-clinical… more
- Texas Health Resources (Arlington, TX)
- …of Milliman or InterQual criteria required + Case management experience preferred + Denials and Appeals experience preferred + RN license to practice in the ... Clinical Reviews, Denial and Appeals RN Bring your passion to THR so we...ancillary departments to proactively address patient care issues and denials management + Conducts the necessary research… more
- Houston Methodist (Houston, TX)
- …leading multi-site or enterprise-level programs preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- ... exposure to confidential/sensitive information + Proven expertise in throughput optimization, denials management , and team leadership across diverse care… more
- McLaren Health Care (Mount Pleasant, MI)
- …and Responsibilities as Assigned:** 1. Supports activities consistent with Integrated Care Management Denials across all MHC subsidiaries. 2. Accountable for ... responsibilities of the role to support the clinical team. 3. Collaborates with the Denials Appeals RN to ensure payer appeal/filing deadlines are met and… more
- Houston Methodist (Houston, TX)
- …with HM performance that demonstrates leadership responsibility **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- ... At Houston Methodist, the Director Case Management & Social Services RN position...of opportunities for appropriate utilization of resources to avoid denials and resource management as it pertains… more