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Jul 21 Clinical Appeals Specialist LPN/RN HCA Shared Services/supply Chain Largo, FL

Clinical Appeals Specialist LPN/RN-08947-91772 Primary Location: United States-Florida-Lar ... Full-time Description Job Summary - Handles appeals requiring clinical input or... more

Jul 21 Case Manager (Non–Clinical Centene Tempe, AZ

arties to ensure appropriate discharge plan, care plan, and coordination of acute care and long term care services. Assists member with filing and resolution complaints and... more

Jul 21 Sr Clinical Appeals RN UnitedHealth Group Sacramento, CA

based, and is located in the Clinical Appeals office in Rancho ... Experience preparing appeals for clinical denials * Expertise with InterQual... more

Jul 20 Clinical Appeals Specialist LPN/RN 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

Jul 20 MLTC - Various Nursing, Clinical, Management and Director Positions Managed Care Organization New York City, NY

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 –... more

Jul 17 Clinical Appeals, Work from home UnitedHealth Group San Diego, CA

more of the following will be preferred: -Appeals experience strong preferred -CPT and/or ICD9 experience is preferred -Managed care experience is strongly... more

Jul 16 Clinical Appeals RN, Work from Home US based UnitedHealth Group Houston, TX

Appeals and Grievances (analyzing, reviewing appeals/grievances) * Clinical ... may perform clinical assessments and clinical audits) * Clinical Writing (writing... more

Jul 15 RN Appeals Nurse Case Manager - Revenue Cycle DeKalb Medical Decatur, GA

for clinical reasons Identify coding or clinical documentation issues and work to ... RELATIONSHIPS: Reports to: Lead Care Manager, Manager Care Management Positions... more

Jul 14 Clinical Director, Quality Services(260428) Kaiser Permanente Fresno, CA

departments, including physicians, clinical and administrative leaders, front-line ... reduce variation in clinical practice and to optimize clinical outcomes. • Directs member... more

Jul 12 Manager, Clinical Pharmacy Services OmedaRx Omedarx Portland, OR

Manager, Clinical Pharmacy Services OmedaRxPortland, OR -or- Seattle,WA Primary Job ... all clinical pharmacist consultant staff for clinical activities. Collaborates with the... more

Jul 10 Consultant Clinical Services Med D CVS Caremark Scottsdale, AZ

Medicare Part D Coverage Determinations and Appeals. This individual will work closely with PA Admin and Medicare Operations to validate the utilization management criteria,... more

Jul 10 RN Supervisor, Utilization Management (Appeals) AmeriHealth Caritas Philadelphia, PA

Under the general supervision of the Appeals Manager the supervisor communicates ... progressively responsible experience in a clinical environment, including utilization... more

Jul 10 Grievance & Appeals Specialist Tenet Healthcare Anaheim, CA

Solutions is currently hiring for an Appeals Writer Specialist. JOB ... the Clinical Resource Center (CRC) for clinical consultations or account referrals when... more

Jul 10 Appeals Specialist Tenet Healthcare Boca Raton, FL

Solutions is currently hiring for an Appeals Writer Specialist. JOB ... the Clinical Resource Center (CRC) for clinical consultations or account referrals when... more

Jul 10 Pharmacist Clinical Med D CVS Caremark Scottsdale, AZ

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

Jul 08 Appeals Analyst(255224) Kaiser Permanente Pasadena, CA

Public Department Name: Clinical Review Special Services Travel : No Job Eligible for Benefits: Yes External hires must pass a background check/drug screen. All qualified... more

Jul 03 Clinical Appeals Coordinator Sharp System Services San Diego, CA

review, denial management, audits and appeals, clinical documentation improvement or ... Chief Medical Officer). This Clinical Appeals Coordinator position is a unit-based... more

Jul 01 CLINICAL APPEALS MANAGER(Case Mgr/RN) Vaco Technology Bethlehem, PA

Job Description - Clinical Appeals Mgr / Case Mgr / RN with management experience, to supp ... Case Management Director to ensure all clinical appeals are being submitted and... more

Jun 27 Appeals and Grievance Manager Amida Care Staten Island, NY

Appeals and Grievance Manager The Appeals and Grievances Associate is responsible for ... which require the interpretation of clinical information, but includes... more

May 23 Nursing Clinical Manager Mount Sinai Health System New York City, NY

Job Title:? ?Nursing Clinical Manager Full/Part Time:? ?Full Time Location/Affiliates:? ? ... ?NR14-1642678 ? Job Description:? The Clinical Nurse Manager (CNM) for Case... more

May 17 Clinical Appeals Coordinator Sharp Memorial Hospital San Diego, CA

denial management, audits and appeals, clinical documentation improvement or related ... work. Keywords: 54483, Clinical Appeals Coordinator RN, Nursing, RN Case Management,... more

May 11 Clinical Nurse Manager - (CNM) Nursesrx Vacaville, CA

ob Description & Requirements Clinical Nurse Manager - (CNM)StartDate: ASAP Available ... to apply.clinical 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

Jul 08 Appeals & Grievances Clinical Specialist (RN) Execu|search Group New York City, 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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