• Registered Nurse ( RN

    LA Care Health Plan (Los Angeles, CA)
    Registered Nurse ( RN ) Manager, Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances ... + Excellent verbal, written communication and presentation skills. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and… more
    LA Care Health Plan (12/09/25)
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  • Appeals Nurse

    Evolent (Springfield, IL)
    …as an RN - **Required** + Minimum of 5 years in Utilization Management , health care Appeals , compliance and/or grievances/complaints in a quality ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...Doing:** + Practices and maintains the principles of utilization management and appeals management by… more
    Evolent (12/24/25)
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  • Registered Nurse , Health Compliance…

    State of Colorado (Denver, CO)
    Registered Nurse , Health Compliance Inspector Home Care - FAA00601 (HP III RN ) Print ... Apply  Registered Nurse , Health Compliance Inspector Home Care - FAA00601 (HP III RN ) Salary $80,916.00 Annually Location Denver,… more
    State of Colorado (01/01/26)
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  • Lead Customer Solution Center Appeals

    LA Care Health Plan (Los Angeles, CA)
    …the ability to manage multiple training initiatives simultaneously. Licenses/Certifications Required Licensed Registered Nurse ( RN ) - Active, current and ... Lead Customer Solution Center Appeals and Grievances RN Job Category:... appeals and grievances experience in a managed care , utilization management and/or case management more
    LA Care Health Plan (11/11/25)
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  • Registered Nurse ( RN )…

    Rochester Regional Health (Rochester, NY)
    Job Title: Registered Nurse I Department: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 hours (Full-Time) Schedule: Monday - ... managed care payment principles helpful + Case Management Certification + At least 3 years RN...Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse -… more
    Rochester Regional Health (12/31/25)
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  • RN Clinical Appeals Nurse

    Molina Healthcare (WI)
    JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals ... health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted… more
    Molina Healthcare (01/02/26)
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  • Registered Nurse Health Compliance…

    State of Colorado (Denver, CO)
    …III RN ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5190465) Apply  Registered Nurse Health Compliance Inspector, Complaints ... Registered Nurse Health Compliance Inspector, Complaints...Section - FAA00731 (HP III RN ) Salary $80,916.00 Annually Location Denver, CO Job Type… more
    State of Colorado (01/08/26)
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  • Registered Nurse I, RN I…

    State of Colorado (Golden, CO)
    Registered Nurse I, RN ...to: healthy lifestyle ie diet, exercise, sleep hygiene, stress management , proper hygiene practices, dental care , STI's ... Mountain, Youth Services Center - Golden Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5185059) Apply  Registered Nurse I, RN I -… more
    State of Colorado (01/03/26)
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  • RN Clinical Review Appeals

    St. Luke's University Health Network (Allentown, PA)
    …the communities we serve, regardless of a patient's ability to pay for health care . The RN Clinical Review Appeals Specialist retrospectively reviews patient ... Works inside with adequate lighting, comfortable temperature and ventilation. EDUCATION: Registered Nurse required, BSN preferred. Current license required. .… more
    St. Luke's University Health Network (10/28/25)
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  • Director Pre Appeals Management -HSO…

    Mount Sinai Health System (New York, NY)
    **Job Description** **Director Pre Appeals Management -HSO Appeals Management -Corporate 42nd Street-Full-Time-Days -Remote** The Director, Pre Appeals ... leader who provides strategic leadership and operational oversight for the hospital's pre- appeals management program. This role ensures the appropriate use of… more
    Mount Sinai Health System (11/01/25)
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