- Cognizant (Phoenix, AZ)
- …need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or 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
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse (RN) Manager, Appeals and Grievances General Operations ( Clinical ) Job Category: Clinical Department: CSC Appeals & Grievances ... (A&G) & General Operations ( Clinical ) is responsible for the daily oversight of clinical appeals and grievances functions within the Appeals & Grievances… more
- McLaren Health Care (Grand Blanc, MI)
- …and commercial insurance. 8. Educates health team colleagues about complex clinical appeals , utilization review, including role, responsibilities tools, and ... duties as required and directed. **Qualifications:** _Required_ + State licensure as a registered nurse (RN) + Bachelor's degree in nursing from accredited… more
- Centene Corporation (New York, NY)
- …of all appeals requests + Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry ... **Hours: 8:30am-5pm EST Monday - Friday.** **Position Purpose:** Performs clinical reviews needed to resolve and process appeals...Vocational Nurse required or + RN - Registered Nurse - State Licensure and/or Compact… more
- CVS Health (OH)
- … resolutions with internal and external support areas. **Required Qualifications** + A Registered Nurse that must hold an unrestricted license in their state ... quality care for members. Administers review and resolution of clinical complaints and appeals . Interprets data obtained from clinical records to… more
- Catholic Health (Buffalo, NY)
- …finance, business management, operational analysis, information systems or related field + Registered Nurse with a four (4) year degree and Unrestricted ... based on role of management and oversight of team Summary: The Clinical Denials and Appeals , Clinical Supervisor is responsible for the people, carrying out… more
- McLaren Health Care (Mount Clemens, MI)
- …outcomes and fulfills the obligation and responsibilities of the role to support the clinical team. 3. Collaborates with the Denials Appeals RN to ensure payer ... other related duties as required and directed. **Qualifications:** **_Required:_** + Registered Health Information Technician (RHIT), Licensed Practical Nurse … more
- State of Colorado (Denver, CO)
- Registered Nurse I-Colorado Mental Health Hospital in Fort Logan-Denver Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5078182) Apply ... Registered Nurse I-Colorado Mental Health Hospital in...During specific shifts, functions in the role of Charge Nurse and provides clinical and administrative supervision… more
- State of Colorado (CO)
- CDOC Registered Nurse ( Nurse I) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4963973) Apply CDOC Registered Nurse ( Nurse ... I Statewide 06/2025 Department Department of Corrections Division Clinical and Correctional Services Opening Date 06/05/2025 Closing Date...Applicant must possess a current, valid license as a Registered Nurse from the Colorado Board of… more
- State of Colorado (Pueblo, CO)
- Nurse I CMHHIP Relief Pool - Registered Nurse I - CMHHIP Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5102074) Apply Nurse I ... CMHHIP Relief Pool - Registered Nurse I - CMHHIP Salary $43.80 - $61.31 Hourly...This position is responsible for assisting nursing staff with clinical direction of nursing staff, QA/PI activities and to… more