- Molina Healthcare (IA)
- … decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical ... **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse who must...with internet connectivity of high speed required **Job Summary** Clinical Appeals is responsible for making appropriate… more
- Evolent (Des Moines, IA)
- …to Standard processing, documenting accordingly. + Works closely with the appeals -dedicated Clinical Reviewers to ensure timely adjudication of processed ... culture. **What You'll Be Doing:** Job Description The Specialty Appeals Team offers candidates the opportunity to make a...and Preferred:** + 1-3 years' experience and as an RN - **Required** + Minimum of 5 years in… more
- CenterWell (Des Moines, IA)
- …or requested. **Use your skills to make an impact** **Required Experience/Skills:** + Registered Nurse or Physical Therapist. + Current state license as a ... and monitoring all payer requests for additional documentation (ADR), appeals and denials. Works with branch staff to gather... Registered Nurse or Physical Therapist. + 5… more
- Trinity Health (Des Moines, IA)
- …Join the MercyOne Family! We are looking to hire a RN Clinical Integration Specialist. The purpose of the ... and Medicaid Services (CMS), Iowa Department of Inspections and Appeals (IDIA), The Joint Commission (TJC),etc.), in conjunction with...Day Shift **General Requirements:** + Iowa licensure as a Registered Nurse . + Member of a professional… more
- Molina Healthcare (Sioux City, IA)
- …resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training and support to clinical ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
- Prime Therapeutics (Des Moines, IA)
- …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
- Trinity Health (Des Moines, IA)
- …RAC Denials management. **MINIMUM KNOWLEDGE, SKILLS AND ABILITIES REQUIRED:** + Current licensure as a registered nurse in the State of Iowa. + Five (5) years ... Family! We are looking to hire a Utilization Review RN ! Responsible for the review of inpatient and outpatient...Collaborates with MercyOne Post Denials team to determine potential appeals or downgrades and documents in STAR. + Ensures… more