• Registered Nurse - Clinical…

    Cognizant (Santa Fe, NM)
    …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...clinic operations . Experience in utilization management to include Clinical Appeals and Grievances, precertification, initial and… more
    Cognizant (10/09/25)
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  • RN Clinical Appeals Nurse

    Molina Healthcare (Albuquerque, NM)
    …for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical /medical ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions… more
    Molina Healthcare (10/18/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Las Cruces, NM)
    …resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training and support to clinical ... (Team will work on set schedule) Looking for a RN with experience with appeals , claims review, and medical coding. **Job Summary** Utilizing clinical knowledge… more
    Molina Healthcare (09/06/25)
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