• Nurse Appeals RN

    Elevance Health (Norfolk, VA)
    ** 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
    Elevance Health (08/08/25)
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  • Clinical Appeals Nurse ( RN )

    Molina Healthcare (GA)
    **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This position will support ... appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of… more
    Molina Healthcare (08/02/25)
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  • Utilization Management Appeals

    Emory Healthcare/Emory University (Atlanta, GA)
    …more **Description** We're seeking under the direction of the **Utilization Management Appeals Professional, Registered Nurse ** is responsible for managing ... **MINIMUM QUALIFICATIONS** : + License - Must have a valid, active unencumbered Registered Nurse license or temporary permit approved by the Georgia Licensing… more
    Emory Healthcare/Emory University (08/08/25)
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  • Clinical Appeals Nurse

    Centene Corporation (Columbia, SC)
    …workplace flexibility. **Position Purpose:** Act as the liaison for all statewide appeals , fair hearings, review organizations, and other external type appeals . ... both State and NCQA requirements. + Review clinical information for all appeals utilizing nationally recognized criteria to determine medical necessity of services… more
    Centene Corporation (08/03/25)
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  • Appeals Registered Nurse

    Evolent (Montgomery, AL)
    …Stay for the culture. **What You'll Be Doing:** Job Description The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part ... of a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of...and Preferred:** + 1-3 years' experience and as an RN - **Required** + Minimum of 5 years in… more
    Evolent (08/08/25)
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  • Registered Nurse Health Compliance…

    State of Colorado (Denver, CO)
    …(HP III RN ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5002223) Apply  Registered Nurse Health Compliance Inspector Home Care - ... Registered Nurse Health Compliance Inspector Home Care -...FAA00601 (HP III RN ) Salary $80,916.00 Annually Location Denver, CO Job Type Full Time… more
    State of Colorado (08/09/25)
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  • Registered Nurse I, RN I…

    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
    State of Colorado (07/16/25)
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  • Registered Nurse ( RN )…

    Rochester Regional Health (Rochester, NY)
    …LICENSES / CERTIFICATIONS: BLS - Basic Life Support - American Heart Association (AHA), RN - Registered Nurse - New York State Education Department ... Job Title: Registered Nurse IDepartment: Utilization Management Location:...UM review findings, initiate and 1st, 2nd, and/or arbitration appeals as needed. Document in all areas that an… more
    Rochester Regional Health (08/02/25)
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  • Registered Nurse ( RN

    LifePoint Health (Hickory, NC)
    * Registered Nurse ( RN ), Clinical Case Manager* PRN * * *Your experience matters* At Frye Regional Medical Center, we are driven by a profound commitment to ... as an employee, but as a person. As a * registered nurse ( RN )* joining our...payer guidelines and discharge financial implications. * Manages denial appeals and chart audit reviews. *7. Case Management* *… more
    LifePoint Health (08/09/25)
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  • CDOC Registered Nurse ( Nurse

    State of Colorado (CO)
    CDOC Registered Nurse ( Nurse I) Print...RN license. 07 Do you possess an active RN license issued by an Enhanced Nurse Licensure ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4963973) Apply  CDOC Registered Nurse ( Nurse I) Salary $7,591.00 - $10,627.00 Monthly… more
    State of Colorado (06/06/25)
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