- CVS Health (Hartford, CT)
- …this position are Monday-Friday 8a-5p in time zone of residence. Position Summary The Appeals Nurse Consultant position is responsible for processing the ... medical necessity of Medicare Part C appeals from both members and providers. This role is...a production role and remains as part of the Nurse Appeal Consultant job code. Primary duties… more
- CVS Health (Hartford, CT)
- …of residence with occasional rotational weekend and holiday coverage. Position Summary The Appeals Nurse Consultant position is responsible for processing ... the medical necessity of Medicare Part C appeals from both members and providers. This role is...a production role and remains as part of the Nurse Appeal Consultant job code. Primary duties… more
- CVS Health (Hartford, CT)
- …US. Standard business hours 8a-5p in time zone of residence Monday - Friday. The Appeals Nurse Consultant position is responsible for processing the medical ... necessity of Medicare appeals for participating providers. Primary duties may include, but are not limited to: Requesting clinical, research, extrapolating pertinent… more
- CareFirst (Owings Mills, MD)
- **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding ... adverse and adverse coverage decisions. The Clinical Appeals Nurse utilizes clinical skills and knowledge...CCM - Certified Case Manager + LNCC - Legal Nurse Consultant Certified **Experience** : 2 years… more
- Kepro (Richmond, VA)
- …for health solutions in the public sector. Acentra seeks a UM Reviewer & Appeals Coordinator RN/LCSW ( Remote within Virginia) to join our growing team. Job ... in a blended role as a clinical reviewer and appeals coordinator. In the clinical reviewer role - you...all determinations within the contractual standard timeframe. *Position is remote , but must reside within the State of Virginia.… more
- Amgen (Sacramento, CA)
- …Must be able to effectively collaborate across all corporate functions-MSLs, TLLs, Nurse Coordinators, Field Access Team, supporting sales teams, etc. + Key account ... by better understanding the customer's needs + Serves as a resource/ consultant to customers and staff regarding payer policies and processes (eligibility… more