- CVS Health (Hartford, CT)
- …US. Standard business hours 8a-5p in time zone of residence Monday - Friday. The Appeals Nurse Consultant position is responsible for processing the medical ... necessity of Medicare appeals for participating providers. Primary duties may include, but...multiple computer system applications in a fast-paced department. Must work independently as well as in a team environment… more
- CVS Health (Lansing, MI)
- …all with heart, each and every day. **Position Summary** CVS Aetna is seeking a dedicated ** Appeals Nurse Consultant ** to join our remote team. In this role, ... will be responsible for processing the medical necessity of Medicare appeals for participating providers. **Key Responsibilities** + Requesting clinical, research,… more
- CVS Health (Baton Rouge, LA)
- …Must reside in Louisiana Responsible for intake, investigation and resolution of appeals , complaints and grievances scenarios for all products, which may contain ... responses from multiple business units. Ensure timely, customer focused response to appeals , complaints and grievance. Identify trends and emerging issues and report… more
- State of Colorado (Pueblo, CO)
- Nurse I - RN Critical Incident/Occurrence Reporter-CMHHIP-Pueblo Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5147450) Apply Nurse I - ... will be considered from residents and non-residents of Colorado. Primary Physical Work Address In Person: Colorado Mental Health Hospital in Pueblo, 1600 W.… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 251212-5613FP-001 Location East Hartford, CT Date Opened 12/16/2025 12:00:00 AM Salary ... + + + Introduction Are you an experienced Registered Nurse looking to make a difference in the lives...4:30 PM + Regular Days Off: Saturday, Sunday + Work schedule flexibility is required to meet the needs… more
- Sacramento County (Sacramento, CA)
- Registered Nurse D/CF (Level I/II) Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/454059) Apply Registered Nurse D/CF (Level I/II) ... pm on: 9/4/2025, 11/6/2025, 1/2/2026, 3/5/2026, 5/7/2026, 7/2/2026, 9/3/2026, 11/5/2026 Registered Nurse D/CF Level I: $62.99 - $76.57 hourly Registered Nurse … more
- Sacramento County (Sacramento, CA)
- Licensed Vocational Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448956) Apply Licensed Vocational Nurse D/CF Salary ... 4/3/2026, 7/2/2026, 10/2/2026 In a detention/correctional facility, the Licensed Vocational Nurse D/CF performs a wide variety of vocational nursing duties,… more
- Community Wellness Partners (Oswego, NY)
- …Maintains open communication with Medical Staff, Administrator, DON, ADON and Pharmacy consultant 23. Attends Nurse Management meetings, Patient Care meetings ... $75K - $85K/Year GENERAL DESCRIPTION: MDS (Minimum Data Set) nurse collects and assesses information for the health and...Issues NOMNC to residents/responsible party and assists with the appeals process, as needed. 20. Completes QA audits as… more
- Sacramento County (Sacramento, CA)
- …+ Basic psychotropic drugs, and their usage. + Basic terminology of psychiatric social work . + Gross anatomy. + Basic medical terminology. Ability to + Establish and ... + Recognize changes in patient's condition or behavior. + Work effectively as a member of a mental health...as a: Either: 1. Psychiatric Technician Or: 2. Registered Nurse Or: 3. Vocational Nurse Note: The… more
- Centene Corporation (Jefferson City, MO)
- …Develop and maintain the audit process and tools related to: authorizations, appeals , quality events, and case management in CCMS; interrater reliability related to ... compliance with the auditing process + Act as a consultant related to system auditing to others in the...others in the unit, department and health plan + Work with staff to identify and resolve authorization load… more