• Clinical Appeals Nurse…

    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...to assist with medical necessity determinations. Key Qualifications: + Registered Nurse with an active unrestricted professional… more
    Blue Cross Blue Shield of Massachusetts (06/26/25)
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  • Clinical Appeals Nurse (RN)

    Molina Healthcare (Jacksonville, FL)
    …for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical /medical ... DESCRIPTION** For this position we are seeking a (RN) Registered Nurse who must be licensed for...with internet connectivity of high speed required **Job Summary** Clinical Appeals is responsible for making appropriate… more
    Molina Healthcare (08/02/25)
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  • Clinical Manager - Provider Appeals…

    Henry Ford Health System (Troy, MI)
    … Clinical Director, Appeals and Grievance. EDUCATION/EXPERIENCE REQUIRED: + Registered Nurse with current Michigan licensure + Bachelor's Degree in ... GENERAL SUMMARY: The Clinical Manager, Provider Appeals supports appeals team members to plan, direct, evaluate, coordinate, and manage the activities… more
    Henry Ford Health System (08/02/25)
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  • Clinical Appeals Supervisor

    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 (07/18/25)
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  • RN Clinical Review Appeals…

    St. Luke's University Health Network (Allentown, PA)
    …Works inside with adequate lighting, comfortable temperature and ventilation. EDUCATION: Registered Nurse required, BSN preferred. Current license required. . ... of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding… more
    St. Luke's University Health Network (07/08/25)
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  • Registered Nurse (RN),…

    LifePoint Health (Hickory, NC)
    * Registered Nurse (RN), Clinical Case Manager* PRN * * *Your experience matters* At Frye Regional Medical Center, we are driven by a profound commitment to ... discrimination and harassment in employment." **Job:** **Nursing* **Organization:** ** **Title:** * Registered Nurse (RN), Clinical Case Manager PRN*… more
    LifePoint Health (07/16/25)
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  • CDOC Registered Nurse - Part-time

    State of Colorado (Sterling, CO)
    CDOC Registered Nurse - Part-time - Sterling Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4992041) Apply  CDOC Registered Nurse ... I SCF 07/2025 Department Department of Corrections Division Clinical and Correctional Services Opening Date 07/01/2025 Closing Date...Applicant must possess a current, valid license as a Registered Nurse from the Colorado Board of… more
    State of Colorado (07/01/25)
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  • CDOC Registered Nurse ( Nurse…

    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 (06/06/25)
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  • Registered Nurse I - Nursing…

    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...an evidence-based project to aid learning and build confidence. Clinical Direction: + Responsible for the direction of all… more
    State of Colorado (07/16/25)
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  • Registered Nurse or Physical…

    CenterWell (Honolulu, HI)
    …or requested. **Use your skills to make an impact** **Required Experience/Skills:** + Registered Nurse or Physical Therapist. + Current state license as a ... and monitoring all payer requests for additional documentation (ADR), appeals and denials. Works with branch staff to gather... Registered Nurse or Physical Therapist. + 5… more
    CenterWell (07/30/25)
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