- Elevance Health (Atlanta, GA)
- ** Nurse Appeals ** **Hybrid 1:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing ... an accommodation is granted as required by law._ The ** Nurse Appeals ** is responsible for investigating and...would provide an equivalent background. + Current active unrestricted RN license to practice as a health professional within… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse ( RN ) Manager, Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances ... + Excellent verbal, written communication and presentation skills. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and… more
- Elevance Health (Chicago, IL)
- ** Appeals Nurse Reviewer I** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... expanding set of clinical domains, including radiology, cardiology and oncology. The ** Appeals Nurse Reviewer I** is responsible for conducting preauthorization,… more
- McLaren Health Care (Grand Blanc, MI)
- …related duties as required and directed. **Qualifications:** _Required_ + State licensure as a registered nurse ( RN ) + Bachelor's degree in nursing from ... **Position Summary:** Responsible for coordinating the appeals process for third party payer denials, primarily...or utilization review experience + Five years of clinical nurse experience in an acute care setting + American… more
- Cognizant (Phoenix, AZ)
- …expectations. **What you need to have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...Maintain working knowledge of applicable health insurers' internal claims, appeals , and retro-authorization as well as timely filing deadlines… more
- CVS Health (OH)
- …clinical resolutions with internal and external support areas. **Required Qualifications** + A Registered Nurse that must hold an unrestricted license in their ... care for members. Administers review and resolution of clinical complaints and appeals . Interprets data obtained from clinical records to apply appropriate clinical… more
- State of Colorado (Golden, CO)
- Registered Nurse I, RN I...of the department's action. For more information about the appeals process, the official appeal form, and how to deliver ... Mountain, Youth Services Center - Golden Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5008113) Apply Registered Nurse I, RN I -… more
- Walgreens (Deerfield, IL)
- …for customers, patients, team members and communities. **Job ID:** 1655228BR **Title:** Registered Nurse ( RN ) Specialty **Company Indicator:** Walgreens ... to defined medications. Evaluates all requests for prior authorizations, appeals and accompanying tasks. + Provides nursing network subject...Associate's degree in Nursing + Current license/registration as an RN ( Registered Nurse ) with the… more
- Beth Israel Lahey Health (Boston, MA)
- …other related duties as required and directed. **Qualifications:** _Required_ + Licensure as a Registered Nurse ( RN ), Massachusetts + Three years of recent ... Summary: In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission status based on the… more
- University of Washington (Seattle, WA)
- …**UW Medical Center-Montlake - Dermatology Clinic** has an outstanding opportunity for a ** Registered Nurse .** **WORK SCHEDULE** + Full time / 100% FTE + ... phototherapy unit + Assist with prior authorizations and insurance appeals for specialty medications **REQUIREMENTS** + 2 years of...nursing experience + Active licensure to work as a Registered Nurse in Washington State + Active… more
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