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
MFM RN - Clinical Manager
Train and develop clinical support staff, manage performance, and ensure a safe and efficient clinical environment. Triage clinically related phone calls and online inquiries, and participate in clinical research trials, adhering to protocols and regulatory guidelines. If you are a dedicated RN with...
RN or LPN $1,200 SIGN ON BONUS
START IMMEDIATELY! $1,200 NEW HIRE BONUS! Interview is conducted via zoom/over the phone and new hire paperwork is completed electronically! BrightStar Care of Tampa & Sun City/ BrightStar Care of Pasco County is hiring Registered Nurses (RN) or Lice RN, LPN, Healthcare, Staffing. ...
Manager, Appeals and Grievances
Work with leadership to establish and implement departmental goals, establish monthly goal review process and implement a plan of action for identified gapsMaintain delegated vendor relationship and ensure vendor performance and compliance measures are metInstitute and manage working relationships w...
Clinical Recruiting and Sourcing Specialist - Remote
Home Office Requirements: - Maximus provides company-issued computer equipment - Reliable high-speed internet service - Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity - Minimum 5 Mpbs upload speeds - Private and secure workspace #ClinicalServic...
Weekend Nurse (LPN or RN)
Work with the Certified Nursing Assistants during shift including assigning and distributing work, performance management, training new staff, and ensuring work is being performed according to facility standards. All applicants will be considered for employment without attention to race, color, reli...
Clinical Operations Training & Optimization Specialist
Unify standards across multiple health care practices Train new care center employees on current practices and standards Assess opportunities and risks during and after implementation of new practices and provide a custom action plan Establish working relationships and collaborate with providers and...
Paramedic OR Nurse - LPN, LVN or RN.
CSL offers the following benefits for this full-time position, most are effective the first day of hire: Options for health care benefits, including choices of plans for medical and prescription drug, dental, and vision coverage; Company-provided basic life insurance and Short- and Long-Term Disabil...
$$ EMTor LPN or RN $$ Bilingual Spanish at Biomat USA, Inc.
Our company has more than tripled its workforce in the last 10 years - **we're growing, and you can grow with us!** For more information visit:. Our company has more than tripled its workforce in the last 10 years - **we're growing, and you can grow with us!** For more information visit:. Grifols pr...
Paramedic OR Nurse - LPN, LVN or RN (Bilingual – English/Spanish)
CSL offers the following benefits for this full-time position: Options for health care benefits, including choices of plans for medical, dental, and vision, prescription drug coverage; Company-provided basic life insurance and Short- and Long-Term Disability; the option to participate in CSL’s 401(k...
Infection Preventionist (RN or LPN)
Certificate/diploma or degree in nursing, or Bachelor's degree (or higher) in microbiology or epidemiology; or Associate's degree (or higher) in medical technology or clinical laboratory science; or completion of training in another related field such as that for physicians, pharmacists, and physici...