Appeals and Grievances Clinical Specialist - RN or LPN
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
RN, LPN, CNA Per Diem and Contract positions in NYC
Clinical Staffing Resources is currently seeking per diem LTC Certified Nursing Assistants (CNA) Licensed Practical Nurses (LPN) Registered Nurses (RN) to work in one of our long-term care facilities in NYC and the Surrounding area. The ideal candidate will have the appropriate state license and exp...
Medical Information Specialist - RN LPN
A company is looking for a Medical Information Specialist II to provide virtual or telephonic support to clients in a clinical dialogue. ...
RN, LPN, CNA Per Diem and Contract positions in NYC
Clinical Staffing Resources is currently seeking per diem LTC Certified Nursing Assistants (CNA) Licensed Practical Nurses (LPN) Registered Nurses (RN) to work in one of our long-term care facilities in NYC and the Surrounding area. The ideal candidate will have the appropriate state license and exp...
Grievance and Appeals Specialist, Clinical
Investigates and coordinates the resolution of routine and complex grievances and appeals according to defined processes and procedures ensuring that required timeframes and regulatory requirements are met, accurate and timely follow up is completed and activities are documented as required. Collabo...
Intake LPN - Radiation
Administer and documents medication under a physician’s order and follows the five (5) medication rights and reduces the potential for medical error. Update and maintain all electronic patient records and assist in transitioning hard copy records to digital format. Record patient information s...
RN Clinical Educator Home Health
The RN Case Manager will manage each patient’s care efficiently and effectively to achieve positive patient outcomes, and be responsible for the overall plan of care and the outcome of that care, including care delivered by other nursing staff (LPN, HHA) who will be directed / supervised by the RN. ...
Head Nurse (RN/BSN)
Including and not limited to a ssigning patient assignments, m edication orders, t raining of new hires and management of a safe environment for staff and patient’s alike with focus on providing efficient, timely and knowledgeable care while ensuring patient satisfaction in every interaction. ...
Manager, Grievance and Appeals, RN
Ensures the accuracy and integrity of data collection and reporting systems to support analysis and reporting of grievances and appeals data for operations and for required CMS and DOH reporting. Ensures regulatory compliance and timely processing for the Medicare and Medicaid appeal and grievance p...
Registered Nurse (BSN/RN)
Work hand-in-hand with Physicians and other healthcare team members to ensure the greatest quality of care for the patient. Monitor and chart vital signs, weight and height Collaborate with a team of healthcare professionals to share expertise and knowledge. Benefits include Tuition Reimbursement, H...
Clinical Services Specialist
Use Evidence-Based Practices, standardized screening tools and clinical judgement to assess for risk to self, others or property as the result of behavioral health concerns and to deliver mobile clinical substance use services in the home and community. The Mobile Clinical Services Specialist will p...