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
Clinical Appeals Specialist RN
A company is looking for a Clinical Appeals Specialist RN (Remote). ...
Per-Diem LPN's or RN's
Compassion Behavioral Health is seeking a dedicated and compassionate Per-Diem Nurse (LPN or RN) to join our clinical team. This position is ideal for an experienced nurse with a passion for mental health and addiction recovery who is looking for flexible, per-diem work. Active and unrestricted LPN ...
Clinical Reviewer - RN LPN
A company is looking for a Clinical Reviewer to utilize clinical expertise for medical record reviews and ensure compliance with regulatory standards. ...
Registered Nurse (RN) & Licensed Practical Nurse (LPN)
Supervises 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. It's a family oriented and teamwork environment where everyone plays an important part...
Appeals and Grievances Supervisor
A company is looking for a Supervisor, Appeals & Grievances - Commercial. ...
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...
Home Healthcare Case Manager RN or LPN
Your responsibilities extend to crafting individualized Plans of Care (POC) based on patient needs and family input, supporting treatment plan adherence, and monitoring overall well-being, medical requirements, and specialist treatments. Your duties also encompass collaborating with the primary doct...
Unit Manager RN LPN
Monitoring inventory levels to ensure that supplies are adequate and ordering more as needed. Reviewing reports and statistics to identify opportunities for improvement in productivity and efficiency. We provide compassionate short- and long-term healthcare and specialized medical support. Managing ...
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...
Per Diem Registered Nurse or Licensed Practical Nurse (RN/LPN): Boca Raton
Current Florida RN or LPN License. Must have experience working with patients with tracheostomies and ventilators. Must have the ability to manage nursing care plans, educate patient and family on appropriate treatment to assist in improving and/or maintaining health. Assist in maintaining a safe wo...