- Molina Healthcare (Las Cruces, NM)
- … 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
- Intermountain Health (Santa Fe, NM)
- **Job Description:** The RCO Audit & Appeals RN Consultant is responsible for consulting on clinical Appeals and Audits for Intermountain Health. The ... Audit/ Appeals RN Consultant will execute clinical audits of...institution. Education is verified + Current licensure as a registered nurse required. + Experience in Microsoft… more
- Molina Healthcare (Las Cruces, NM)
- …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
- Prime Therapeutics (Santa Fe, NM)
- …Patient Programs. **Minimum Qualifications** + Associates - Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - ... these cases in web-based application and spreadsheets. + Supports clinical services such as the appeals program....for work visa or residency sponsorship **Additional Qualifications** + Registered Nurse ( RN ). + Oncology… more
- Indian Health Service (Dulce, NM)
- …Package - Check out IHS's outstanding total compensation package for this job: Registered Nurse Total Compensation | Pay (ihs.gov) Requirements Conditions of ... (PRC) of Jicarilla Service Unit. The primary responsibilities involve providing clinical case management support to the Purchase/Referred Care Program, coordinating… more