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Jul 29 Hospice Director of Clinical Management/Registered Nurse Required Gentiva Health Services Indianapolis, IN

my work is my calling. As a RN Director of Clinical Management, you will: * Maintain ... certification/recertification process, and clinical oversight issues. * Responsible for... more

Jul 26 Senior Clinical Appeals RN UnitedHealth Group Phoenix, AZ

experience * Experience preparing appeals for clinical denials * Expertise with ... Managed Care, Commercial, Medicare, Clinical Appeals, RAC, Recovery Audit, Phoenix,... more

Jul 25 Clinical Appeals RN I Samaritan Health Services Corvallis, OR

Clinical Appeals RN I Our passion is providing world-class health care. On the job and ... is currently recruiting for the Clinical Appeals RN I who will perform clinical appeal... more

Jul 25 Clinical Appeals Nurse Specialist Parallon Richmond, VA

Center is seeking a motivated Full Time Day Clinical Appeals Specialist . This position ... for clinical reasons. Identify coding or clinical documentation issues and works to... more

Jul 24 RN or LPN Appeals and Grievance Clinical Specialist Healthfirst New York City, NY

information about this job: Overview: The Appeals & Grievances Clinical Specialist is ... appeals and grievances involving review of clinical information. Responsibilities:... more

Jul 24 Pharmacist Clinical (Med D) CVS Caremark Solon, OH

Responsible for reviewing clinical coverage determinations and appeals, maintaining ... interpersonal skills * Ability to balance clinical knowledge and customer service... more

Jul 24 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

Jul 23 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 23 Clinical Appeals RN Work from Home UnitedHealth Group Phoenix, AZ

The position is responsible for handling clinical reviews for Medicare member appeals ... associated with the clinical reviews on all appeals and grievances and ascertain that... more

Jul 22 Clinical Appeals Specialist LPN/RN CIN HCA Shared Services/supply Chain Mason, OH

Clinical Appeals Specialist LPN/RN CIN-26600-90178 Primary Location: United States-Ohio-Ma ... Full-time Description Job Summary - Handles appeals requiring clinical input or... more

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 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 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 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 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 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 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 02 Appeals and Grievance Specialist Boston Medical Center Healthnet Plan Boston, MA

continuity within the Plan. * Works with clinical staff to investigate grievances ... and/or pharmacy prior authorization and appeals process... 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

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 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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