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Apr 23 Clinical Appeals Program Manager Cancer Treatment Center of America Zion, IL

Clinical Appeals Program Manager (Zion IL)Location:Cancer Treatment Centers of America ... Mother Standard.The Clinical Appeals Program Manager (CAPM) is responsible for... more

Apr 21 MLTC - Various Nursing, Clinical, Management and Director Positions Managed Care Organization New York

from Jr. to Director positions• Appeals and Grievance Department Managers – RN Required• QC Managers (HEDIS)- LCSW, LPN or RN +4 year degree (telecommute)• PI/QI/ QA Managers – RN... more

Apr 19 Registered Nurse - Clinical Documentation Specialist Providence Health & Services Everett, WA

Providence is calling an RN Clinical Documentation Specialist to Providence Regional ... queries to physicians, and recognize clinical documentation opportunities for... more

Apr 19 Clinical Appeals Specialist RN WFH Parallon Norcross, GA

Handles appeals requiring clinical input or interpretation SUPERVISOR - Logging Manager SU ... companies toresolve claims denied for clinical reasons? Identify coding or clinical... more

Apr 18 Appeals Nurse Utilization Review Three Rivers Community Hospital Grants Pass, OR

Appeals Nurse Utilization ReviewDepartment: Discharge Planning/UR TRMCSchedule: Part TimeH ... by formulating a strategy for appeals for clinical medical necessity and administrative... more

Apr 18 Appeals Coordinator Cameron Craig Group Pittsburgh, PA

precedence with key payers. Leverage clinical expertise related to cardiac care; ... case manager or discharge planner. Excellent clinical skills related to cardiac disease... more

Apr 15 Pharmacy Technician Prior Authorization and Appeals (157587BR) CVS Caremark Honolulu, HI

all approvals and denials, and transfers all clinical questions and judgement calls to the pharmacist. Required Qualifications Ability to deal with a diverse customer base in a... more

Apr 14 Clinical Appeals Specialist RN/LPN (WFH) Parallon Largo, FL

Job Summary – Handles appeals requiring clinical input or interpretation Key ... for clinical reasons Identify coding or clinical documentation issues and work to... more

Apr 12 RN/ Registered Nurse Clinical Appeals Horizon Healthcare Staffing Brooklyn, NY

RN/Registered Nurse Clinical Appeals Excellent opportunity ! Horizon Healthcare is seeking ... reviews for provider and vendor appeals RN/Registered Nurse Clinical Appeals... more

Apr 11 RN Case Manager - Appeals Adventist Healthcare Rockville, MD

Hospital is searching for a RN Case Manager with appeals experience! This is a ... Case Management experience with appeals requiredStrong customer service... more

Apr 09 Product Manager EMR Clinical Software Thorndale Partners Boston, MA

Product Manager ndash EMR Clinical Record software (Boston, MA) Core Requirements 2+ years ... environment. Strong understanding of clinical work flow and vernacular Experience... more

Apr 09 Pharmacist Clinical Med D (151796BR) CVS Caremark Scottsdale, AZ

Responsible for reviewing clinical appeals, coverage determinations & exceptions, ... the organization. Required Qualifications *Clinical pharmacy knowledge *Data review... more

Apr 08 Clinical Nurse Manager - (CNM) American Mobile Vacaville, CA

As part of his/her administrative duties, the nurse manager may address any of the followi ... to applyclinical nurse manager, nurse manager, clinical manager RN, registered... more

Apr 07 Care Manager Audit Appeals (129990) Texas Children's Hospital Houston, TX

The Care Manager - Audit/Appeals (Appeals) has primary accountability for managing the app ... The Care Manager - Audit/Appeals (Appeals) maintains the ability to function as a member o... more

Apr 04 Clinical Nurse Manager - (CNM) Nursechoice Vacaville, CA

As part of his/her administrative duties, the nurse manager may address any of the followi ... to apply.clinical nurse manager, nurse manager, clinical manager RN, registered... more

Mar 18 Member Services Clinical Consultant(236005) Kaiser Permanente Oakland, CA

Provides/gathers clinical expertise for areas of compliance which involve medical necessit ... Utilizes clinical expertise to conduct investigations and seek input from other clinical p... more

Mar 13 Clinical Nurse Manager - (CNM) Medical Express Vacaville, CA

As part of his/her administrative duties, the nurse manager may address any of the followi ... to apply.clinical nurse manager, nurse manager, clinical manager RN, registered... more

Mar 12 RN Manager of Appeals/Denials Capital Regional Medical Center Tallahassee, FL

Job Description RN Manager of Appeals/Denials(Job Number: 25086-5566) Description : POSITI ... and appeals program. The Senior Manager of Appeals and Denials will work to ensure... more

Mar 10 Registered Nurse RN Clinical Appeals Specialist Multicare Health System Tacoma, WA

Summary: The RN Clinical Appeals Specialist is responsible ... coordination; management and resolution of clinical denials for the Access Services... more

Feb 25 Rep III Clinical Med D (139036BR) CVS Caremark Richardson, TX

that communicate our clients' PA and Appeals implementation needs. The Rep III ... Medicare Part D Coverage Determinations and Appeals. This individual will work closely... more

Feb 25 Registered Nurse for Clinical Documentation Specialist at Memorial Health Tenet Healthcare Chattanooga, TN

education. * CDI: Communicates/Completes Clinical Documentation Improvement (CDI) ... and professionally with other clinical and non-clinical clients *... more

Jan 23 Clinical Review Coordinator - RN Jawood Southfield, MI

Duties include: Perform timely initial clinical review as well as provider appeals ... Medical and surgical procedures requiring clinical review/individual consideration e.g. more

Jan 23 Lead Clinical Appeals Nurse Sinai Hospital of Baltimore Baltimore, MD

Lead Clinical Appeals Nurse Oversees the LBH clinical appeals daily operations and ... Minimum of two years experience in case management/utilization management/clinical appeals... more

Jul 08 Appeals & Grievances Clinical Specialist (RN) Execu|search Group Manhattan, NY

Appeals & Grievances Clinical Specialist (RN) Appeals & Grievances Clinical Specialist ... case manager to take on a role as an Appeals & Grievances Clinical Specialist. more

Jun 10 Medical Audit Appeals Spec (RN or RHIA) (127582) Texas Children's Hospital Houston, TX

Job Description Job Title Medical Audit/Appeals Spec (RN or RHIA) Job ID 127582 Locat ... of appeals and specific time limitations for appeals. Skills Required for completely... more

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