A company is looking for an Appeals and Grievances Clinical Specialist - RN or LPN, 100% Remote.Key ResponsibilitiesManage clinical case development and resolution for member and provider complaintsPrepare cases for Medical Director Review and external appeals processesEnsure compliance with Federal and State regulations while managing caseloadsRequired QualificationsMust be an RN, LPN, or Dental HygienistBachelor's degree preferredExperience in clinical practice, appeals & grievances, or utilization managementUnderstanding of Utilization Review Guidelines and related regulationsAbility to work with care management systems and multiple computer applications
Complaints and Grievances Specialist
A company is looking for a Complaints & Grievances Specialist II to handle investigations and resolutions of complaints and grievances. ...
Registered Nurse (RN) - OR
Documents accurately and submits timely nursing notes and reports, according to agency and facility standards. Registered Nurse (RN)Position Description: A Registered Nurse and Licensed Practical Nurse is a professional member of the health care team who provides skilled nursing care to clients unde...
Clinical Nurse Coordinator, RN - Emergency Dept
In collaboration with other members of the management team, the CNC directs, monitors, and evaluates nursing care in accordance with established policies/procedures, serves as a resource person for staff, and models a commitment to the organization's vision/mission/values to support an unparalleled ...
Main OR Clinical Nurse Coordinator RN Weekends
In collaboration with other members of the management team, the CNC directs, monitors, and evaluates nursing care in accordance with established policies/procedures, serves as a resource person for staff, and models a commitment to the organization’s vision/mission/values to support an unparalleled ...
Care Transitions Coordinator Home Health - RN or PT
We are committed to a work environment that supports, encourages and motivates all individuals without discrimination on the basis of race, color, religion, sex (including pregnancy or related medical conditions), sexual orientation, gender identity, marital status, age, disability, national or ethn...
RN - Clinical Team Leader - Home Health
We are committed to a work environment that supports, encourages and motivates all individuals without discrimination on the basis of race, color, religion, sex (including pregnancy or related medical conditions), sexual orientation, gender identity, marital status, age, disability, national or ethn...
Field Application Specialist, Clin Lab & Transfusion Medicine - Corpus Christi
QuidelOrtho believes in Equal Opportunity for all and is committed to ensuring all individuals, including individuals with disabilities, have an opportunity to apply for those positions that they are interested in and qualify for without regard to race, religion, color, national origin, citizenship,...
RN or LVN - All Shifts
Forest Park Nursing & Rehabilitation provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran statu...
Clinical Liaison - NeuroTransitional Center ( RN , PT , OT , SLP )
Qualified applicants are considered for employment, and employees are treated during employment without regard to race, color, religion, national origin, citizenship, age, sex, sexual orientation, gender identity, marital status, ancestry, physical or mental disability, veteran status, or any other ...
Academic Professional Track (Non-Tenure): Clinical or Instructional Open Rank and Director of the Rural Medicine Education Program
Exhibiting conduct consistent with the philosophy and mission of the College of Medicine while understanding accreditation standards and expectations specific to the department and adheres to policies and procedures to meet or exceed such standards . Applicants will be considered for the faculty tit...