• RN Clinical Appeals Nurse Remote

    Molina Healthcare (Lincoln, NE)
    JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests ... reviews of previously denied cases in which a formal appeals request has been made or upon request by...equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in… more
    Molina Healthcare (01/02/26)
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  • Appeals Nurse

    Evolent (Lincoln, NE)
    …for the mission. Stay for the culture. **What You'll Be Doing:** 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 utilization management by adhering to Evolent and… more
    Evolent (12/24/25)
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  • Pediatric Nurse Practitioner Critical Care…

    Omaha Children's Hospital (Omaha, NE)
    …be considered. Children's Nebraska has an exciting opportunity to join our ** Nurse Practitioner Critical Care** **Transport** team! Our **Pediatric Nurse ... helicopter and a Pilatus PC-12 fixed-wing aircraft. The Pediatric Nurse Practitioner Transport Provider is responsible for managing the...activities and is home to a world-class zoo that appeals to children and adults alike. Greater Omaha has… more
    Omaha Children's Hospital (10/14/25)
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  • Neonatal Nurse Practitioner - Transport

    Omaha Children's Hospital (Omaha, NE)
    …Children's Nebraska has an exciting opportunity to join our **Neonatal Nurse Practitioner** **Transport** team! Our NNPs work collaboratively with flight nurses ... of Nebraska offers a unique opportunity for a Neonatal Nurse Practitioner (NNP) to join our dedicated neonatal transport...activities and is home to a world-class zoo that appeals to children and adults alike. Greater Omaha has… more
    Omaha Children's Hospital (11/06/25)
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  • Medical Director (NV)

    Molina Healthcare (Omaha, NE)
    …medical necessity. * Participates in and maintains the integrity of the appeals process, both internally and externally. * Responsible for investigation of adverse ... and recommends corrective actions. * Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. * Attends… more
    Molina Healthcare (11/21/25)
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  • Care Review Clinician (RN)

    Molina Healthcare (Bellevue, NE)
    For this position we are seeking a (RN) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity of high ... set schedule) Looking for a RN with experience with appeals , claims review, and medical coding. JOB DESCRIPTION Job...equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in… more
    Molina Healthcare (12/24/25)
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  • Clinical Document Integrity Specialist / Health…

    Omaha Children's Hospital (Omaha, NE)
    …final APR-DRG, severity of illness and/or risk of mortality. Assists in the appeals process resulting from third-party reviews. + Educates physicians and key health ... + RHIT - Registered Health Information Technician Preferred or + CPN - Certified Pediatric Nurse Preferred Children's is the very best for kids and the very best for… more
    Omaha Children's Hospital (12/29/25)
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