• Clinical Appeals Nurse

    R1 RCM (Salt Lake City, UT)
    …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
    R1 RCM (05/20/25)
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  • Clinical Appeals Nurse…

    Molina Healthcare (Provo, UT)
    … decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making...these guidelines. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
    Molina Healthcare (05/16/25)
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  • Clinical Coding Appeals Nurse

    R1 RCM (Salt Lake City, UT)
    …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Coding Appeals Nurse ** , you will help ... position. **Here's what you will experience working as a Clinical Coding Appeals Nurse :** +...external compliance deadlines are met. **Required Skills:** + Active Registered Nurse license + An active CCS,… more
    R1 RCM (05/21/25)
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  • Clinical Appeals Supervisor

    R1 RCM (Salt Lake City, UT)
    …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 (04/18/25)
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  • Appeals Nurse

    Evolent (Salt Lake City, UT)
    …to Standard processing, documenting accordingly. + Works closely with the appeals -dedicated Clinical Reviewers to ensure timely adjudication of processed ... for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a...and Preferred:** + 1-3 years' experience and as an RN - **Required** + Minimum of 5 years in… more
    Evolent (05/10/25)
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  • RN Medical Claim Review Nurse

    Molina Healthcare (Layton, UT)
    …resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training and support to clinical ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
    Molina Healthcare (05/21/25)
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  • Utilization Management-Utilization Review…

    Intermountain Health (Murray, UT)
    …+ Resourceful + Verbal and Written Communication **Qualifications** Minimum Qualifications + Current RN ( Nurse ) compact license to practice in all states that ... **Essential Functions** + Reviews and investigates medical record and applies clinical expertise to assure appropriate benefit utilization, + Uses in-depth knowledge… more
    Intermountain Health (05/21/25)
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