• RN Clinical Appeals…

    Molina Healthcare (Tampa, FL)
    … 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 (10/04/25)
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  • Appeals Nurse Reviewer I

    Elevance Health (FL)
    …set of clinical domains, including radiology, cardiology and oncology. The ** Appeals Nurse Reviewer I** is responsible for conducting preauthorization, out ... ** Appeals Nurse Reviewer I** **Location:** This...reviews for diagnostic imaging services by utilizing appropriate policies, clinical and department guidelines. **How you will make an… more
    Elevance Health (09/26/25)
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  • Medical Claim Review Nurse ( RN )

    Molina Healthcare (Tampa, FL)
    …hours 6 AM to 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals , claims review, and medical coding. **Job Summary** Utilizing ... resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training and support to clinical … more
    Molina Healthcare (09/06/25)
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  • Infusion Referral Nurse - REMOTE

    Prime Therapeutics (Tallahassee, FL)
    …visa or residency sponsorship. **Additional Qualifications** + Registered Nurse ( RN ). + 5 years of post-degree clinical experience. + Experience in ... these cases in web-based application and spreadsheets. + Supports clinical services such as the appeals program....+ Associates - Nursing + Bachelors - Nursing + RN - Registered Nurse , State… more
    Prime Therapeutics (10/04/25)
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  • RN GYN Oncology PRN

    AdventHealth (Orlando, FL)
    …of professional nursing theory and practice to give and evaluate patient care. The Registered Nurse ( RN ) is responsible for providing and supervising direct ... ** RN Specialty Care Oncology PRN AdventHealth Medical Group...than 800 physicians, 450 advanced practice providers, and 2,600 clinical and support staff in over 40 specialties, provide… more
    AdventHealth (10/04/25)
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