- Vivo HealthStaff (Burbank, CA)
- …policies and influence process improvements. Qualifications: 1. Graduate from an accredited Registered Nursing Program; RN preferred. 2. Minimum of five years ... Job Description: Clinical Supervisor, UM Denial Compliance Location: Los Angeles...Location: Los Angeles Metropolitan Area Position Type: Hybrid (85% remote , 15% onsite in Burbank, CA) Company: Vivo HealthStaff… more
- Kaiser Permanente (Aurora, CO)
- …region. Manages utilization review staff working collaboratively with UM physicians and clinical appeals team, supervises the activities of the unit staff, ... required. License, Certification, Registration Licensed Social Worker (Colorado) OR Registered Nurse License (Colorado) Additional Requirements: Thorough… more
- Blue Shield of California (Long Beach, CA)
- …Description Work Schedule M-Th 10:30-7:00 F 9:30-6:00 Your Role The Behavioral Health Registered Nurse Case Manager will report to the FEP Department Manager. ... integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those… more
- Molina Healthcare (Midvale, UT)
- … decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical ... **JOB DESCRIPTION** _For this position we are seeking a ( RN ) Registered Nurse who must...with internet connectivity of high speed required._ **Job Summary** Clinical Appeals is responsible for making appropriate… more
- State of Colorado (Golden, CO)
- Registered Nurse I, RN I - Campus at Lookout Mountain, Youth Services Center - Golden Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5019028) Apply Registered Nurse I, RN I - Campus at Lookout Mountain, Youth Services Center… more
- Centene Corporation (Sacramento, CA)
- …of all appeals requests + Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry ... fresh perspective on workplace flexibility. + **This position requires RN California Licensure and for candidates to have a...work M-F 8-5 PST Hours.** + **Position Purpose:** Performs clinical reviews needed to resolve and process appeals… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- Ready to help us transform healthcare? Bring your true colors to blue. The RoleThe Clinical Appeals Nurse Reviewer is responsible for applying sound ... an integral part of the Appeal Review team, the Clinical Appeals Nurse Reviewer will...remote ). Key Responsibilities: + Review provider and member appeals utilizing sound clinical judgement, medical policy,… more
- State of Colorado (Pueblo, CO)
- Registered Nurse I - Nursing Residency Program - CMHHIP - Pueblo Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5007135) Apply ... Registered Nurse I - Nursing Residency Program...updates on CDHS recruiting events! CDHSCareers Description of Job RN Residency Program Objective: This position will provide novice… more
- R1 RCM (Boise, ID)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals Supervisor** , you will help support clinicians ... position. **Here's what you will experience working as a Clinical Appeals Supervisor:** + Track and monitor...for additional support and engagement. **Required Skills:** + Active Registered Nurse license For this US-based position,… more
- R1 RCM (Boise, ID)
- …platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals Nurse ** , you will help our ... position. **Here's what you will experience working as a Clinical Appeals Nurse :** + Conduct...at telephonic hearings if needed. **Required Skills:** + Active Registered Nurse license For this US-based position,… more
