- Hackensack Meridian Health (Hackensack, NJ)
- …our mission to transform healthcare and serve as a leader of positive change. The ** Appeal Nurse Specialist ** will be responsible for the timely review and ... and Care Management). **Responsibilities** A day in the life of a ** Appeal Nurse Specialist ** at **Hackensack Meridian** **_Health_** includes: + Reviews all… more
- Iowa Department of Administrative Services (Woodward, IA)
- Nurse Specialist Print (https://www.governmentjobs.com/careers/iowa/jobs/newprint/4526606) Apply Nurse Specialist Salary $65,395.20 - $101,150.40 ... Health & Human Services (HHS) facility, is seeking a Nurse Specialist to join our team. This...submitting any information related to an application, examination, certification, appeal , or any other facet of the selection process… more
- State of Colorado (CO)
- CDOC Nurse Supervisor Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4383689) Apply CDOC Nurse Supervisor Salary $7,965.00 Monthly ... Location Statewide, CO Job Type Full Time Job Number CAA Nurse III 2/2024 Department Department of Corrections Division Clinical and Correctional Services Opening… more
- State of Colorado (CO)
- CDOC Registered Nurse ( Nurse I) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4394165) Apply CDOC Registered Nurse ( Nurse I) ... Monthly Location Statewide, CO Job Type Full Time Job Number CAA Nurse I Statewide 2/2024 Department Department of Corrections Division Clinical and Correctional… more
- State of Colorado (Canon City, CO)
- CDOC Licensed Practical Nurse (LPN) -- Canon City Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4511336) Apply CDOC Licensed Practical ... Nurse (LPN) -- Canon City Salary $3,832.00 - $5,364.00...your records** Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights MINIMUM QUALIFICATIONS: Applicant must possess a current,… more
- Alameda Health System (San Leandro, CA)
- Care Management Clinical Appeals Specialist + San Leandro, CA + Finance + Patient Financial Svcs - Facil + Full Time - Day + Business Professional & IT + Req ... FTE:1 + Posted:February 8, 2024 **Summary** **SUMMARY:** Coordinates and executes the appeal process for all AHS facilities clinical appeals and third party audits.… more
- Clark County, NV (Las Vegas, NV)
- YOUTH & ADULT INTERVENTION SPECIALIST I/II Print (https://www.governmentjobs.com/careers/clarkcounty/jobs/newprint/4526235) Apply YOUTH & ADULT INTERVENTION ... SPECIALIST I/II Salary $29.44 - $49.33 Hourly Location Clark...and the employee will be terminated without right of appeal when such funds are no longer available. MINIMUM… more
- Baystate Health (Greenfield, MA)
- …Management Specialist (UMS)/Hospital Case Manager (HCM) is a Registered Nurse (RN) responsible for the coordination of care, quality and financial outcomes ... Medical Center** is looking for a **Per Diem** **Registered Nurse (RN), Case Manager** to join our Hospital Case...researches and responds to all medical and behavioral health appeal inquiries and requests, in accordance with contractual, account,… more
- Trinity Health (Farmington Hills, MI)
- …and Administrative/Technical accounts, focusing upon retrospective follow-up and appeal processing) with the objective of appropriately maximizing reimbursement ... the various impacted departments + Coordinates rejection, denial and appeal activities with Ministry Organization (MO) based Utilization Review/Case Management… more
- BrightSpring Health Services (Louisville, KY)
- Our Company BrightSpring Health Services Overview The Clinical Coding and Audit Specialist monitors, responds and performs the clinical coding and audit support ... patient safety surveys + Formulates and submits letters of appeal . Creates an effective appeal utilizing relevant...a current license/registration by state of hire as a nurse + Successfully completed HCS-D coding certification, required and… more
- Banner Health (Queen Creek, AZ)
- …let us help you on start your journey with Banner Health. The Registered Nurse Operations Support Specialist coordinates the educational and on-boarding needs of ... that support visibility and team work. Our physicians and nurse practitioners are very engaged in the plan of...Earn Trust, and Customer Obsessed. If living these values appeal to your path as a health care professional,… more
- Molina Healthcare (TX)
- **_For this position we are seeking a REGISTERED NURSE (RN) with prior experience in Utilization Review / Utilization Management and knowledge of Interqual / MCG ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases… more
- Corewell Health (Royal Oak, MI)
- …Michigan's first Diagnostic Imaging Center of Excellence. Scope of work The NPD- Specialist develops tools, theories, skills and knowledge to advance the practice of ... in education and professional development practices, the NPD Practitioner Specialist (NPD-S) functions autonomously and in collaboration with staff, leadership,… more
- HonorHealth (Scottsdale, AZ)
- …Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of health care services with the ... of services). Collaborates with physicians, case managers, payers and others to appeal individual denials and trended issues related to contract guidelines. Works… more
- Trinity Health (Farmington Hills, MI)
- …manner possible: + Coordinates follow-up activities with Utilization Review/Case Management/Coding/ Nurse Liaison to provide required clinical support, as well as ... payers, and supplying additional data, as required. + Composes adjustment and appeal letters to resolve payment rejections and/or denials. + Updates and refiles… more
- Elderwood (Grand Island, NY)
- …$34.00 / hour Elderwood at Grand Island is seeking a Memory Care Program Specialist with excellent communication and customer service skills. This is a full time ... residents with therapeutic and social activities/situations that are designed to appeal to residents' interests and enhance the resident's highest practicable level… more
- Albany Medical Center (Albany, NY)
- …Salary Range: Min. $23.96/hr - Max $38.34/hr The Clinical Pre-Authorization Specialist will assist the Patient Engagement Center Liaison, Representatives and other ... related to pre-authorizations; work with Patient Financial Services in the appeal process based on internal guidelines. Assists Manager, Pre-Service Operations -… more
- Ascension Health (Chicago, IL)
- …your Talent Advisor for additional specifics._ **Responsibilities** Manage assigned Registered Nurse (RN) case managers, related activities, and workflow to ensure ... planning, and length of stay. + Serve as content specialist for staff in the areas of utilization criteria,... for staff in the areas of utilization criteria, appeal , and review process, and case management system documentation.… more
- CDPHP (Albany, NY)
- …you to be a part of that experience. The Clinical Review and Coding Nurse is responsible to attain procedure and diagnosis coding accuracy and consistency on ... The RN will perform and coordinate the clinical component of the provider appeal function including communication of the decision on whether to uphold the original… more
- State of Colorado (Limon, CO)
- …for your records** Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights MINIMUM QUALIFICATIONS: + Applicant must possess current, valid ... licensure as an Advanced Practice Nurse / Nurse Practitioner from the Colorado...professionals must check their licensing requirements regarding marijuana use. Appeal Rights: If you receive notice that you have… more