- CVS Health (Hartford, CT)
- …**Position Summary** Responsible for the review and resolution of clinical appeals . Reviews documentation and interprets data obtained from clinical records to ... as required. This position may support UM, MPO, Coding, or Behavioral Health appeals . **Required Qualifications** * Must have active and unrestricted RN licensure in… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Appeals and Grievances Clinical Operations RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 ... safety net required to achieve that purpose. Job Summary The Supervisor of Appeals and Grievances Clinical Operations (A&G) RN is responsible for executing the… more
- SSM Health (OK)
- …or WI)* Qualifications: 2+ years of Utilization Review experience, denials and appeals experience, and knowledge of evidence-based guidlines (MCG and InterQual) _*If ... possible reconsideration with payor. + Collaborates with physician (advisor, attending, consultant regarding peer to peer and appeal). + Monitors results of… more
- Sacramento County (Sacramento, CA)
- Registered Nurse D/CF (Level I/II) Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/454059) Apply Registered Nurse D/CF (Level I/II) ... at 5:00 pm on: 11/6/2023, 1/2/2024, 3/5/2024, 5/7/2024, 7/2/2024, 9/3/2024, 11/5/2024 Registered Nurse D/CF Level I: $61.27 - $74.48 hourly Registered Nurse D/CF… more
- Sacramento County (Sacramento, CA)
- Licensed Vocational Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448956) Apply Licensed Vocational Nurse D/CF Salary ... on: 4/4/24, 7/5/24, 10/3/24 In a detention/correctional facility, the Licensed Vocational Nurse D/CF performs a wide variety of vocational nursing duties, including… more
- Sacramento County (Sacramento, CA)
- Registered Nurse Level I/II Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/2579173) Apply Registered Nurse Level I/II Salary $45.21 - ... Note: Vacancies may be permanent or intermittent on-call. Registered Nurse Level I: $45.21 - $54.95 hourly Registered ...Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days… more
- American Red Cross (KY)
- …and their family and other attending healthcare professionals. + Act as a consultant to external health care personnel about clinical apheresis. + Assess patient ... Qualifications_** **):** + **Current state licensure as a Registered Nurse and CPR certification is required** **.** + **Bachelor's...make a difference by volunteering in a position that appeals to you and allows you to use your… more
- Sacramento County (Sacramento, CA)
- …of California to practice as a: Either: 1. Psychiatric Technician Or: 2. Registered Nurse Or: 3. Vocational Nurse Note: The word "experience" referenced in the ... language other than standard English; and/or act as a consultant to others regarding the needs and problems presented...Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days… more
- Clark County, NV (Las Vegas, NV)
- …and oversees the work of contract professionals; negotiates and administers consultant contracts. Coordinates and assists in the processing of applications submitted ... retail or mail order fills) + 24/7 Telephone Advice Nurse - no employee cost + Teledoc, Doctoroo, and...applicant's response to each item in the assessment, score appeals will not be allowed for this recruitment. +… more
- Alameda Health System (Oakland, CA)
- …and internal compliance studies. + Oversees the secondary review process; actively appeals denied cases when necessary and assists physicians with appeals . ... and/or techniques. + Review cases regularly with staff; acts as clinical consultant regarding care management issues; guides clinical staff with review of… more