A company is looking for a Manager, Clinical Appeals.Key Responsibilities : Assist in coordination and management of the clinical appeals process related to adverse benefit determinationsOversee clinical appeals data and processes to maintain industry standards and practicesAnalyze under and over utilization information for impact on member quality of care and outcomesRequired Qualifications, Training, and Education : Associate's Degree in Nursing required, Bachelors of Science in Nursing (BSN) preferredMinimum of five years of clinical experienceMinimum of five years of experience in utilization management, appeals, and / or quality improvementTwo years of utilization management or appeals experience preferredCurrent, unrestricted licensure in state of practice as a Registered Nurse (RN) required
Clinical Appeals Manager
A company is looking for a Manager, Clinical Appeals. ...
Clinical Appeals Nurse Manager
A company is looking for a Clinical Appeals Nurse Manager. ...
Registered Nurse (per Diem) Labor & Delivery
Note: An RN graduate is a nurse who has completed a course of study at a school of nursing and is eligible for the NCLEX. The RN graduate performs directly under the supervision of the Charge Nurse or RN designee. ...
Travel Registered Nurse - Intensive Care Unit - ($2400/Week) in LA, California
Travel Registered Nurse - Intensive Care Unit - ($2400/Week). ...
Travel Registered Nurse - $1,720 to $1,873 per week in Reno, NV
Host Healthcare is an award-winning travel healthcare company with an immediate opening for this .Passionate and transparent team members have made Host Healthcare the agency of choice for new and experienced travelers looking for opportunities far away and close to home.Starting the day you apply, ...
Travel Registered Nurse - Labor/Delivery - $2,070 per week in Elko, NV
TravelNurseSource is working with Core Medical Group to find a qualified Labor/Delivery RN in Elko, Nevada, 89801!. CoreMedical Group has hundreds of exciting and rewarding travel assignments throughout the country for Travel Allied Professionals and Travel Nurses. As a travel allied professional or...
Registered Nurse (rn) Critical Care Float Pool (nights)
The Women's Center maternity services include labor, delivery and recovery rooms, antepartum and postpartum care, a newborn nursery and a. The Rn graduate performs directly under the supervision of the Charge Nurse or RN designee. An RN graduate is a nurse who has completed a course of study at a sc...
Clinical Pharmacist
The essential functions of a Pharmacists in Prior Authorization are reviewing Prior Authorization cases and rendering coverage determinations based on clinical criteria and plan design in a fast paced and dynamic environment. This position is for a Clinical Pharmacist working in the Prior Authorizat...
Registered Nurse (RN)
Performs all essential functions under thedirection of the Supervisor and with guidance from the ClinicalEducator, Preceptor or in collaboration with other RegisteredNurses. Assigned oversight of Patient Care Technicians/LPNs/LVNs/RNs as aTeam Leader or designated Nurse in Charge, after meeting all ...
Remote Administrative Assistant (No Experience Required) - Earn $25/hr-$45/hr, Full-Time/Part-Time, Flexible hours
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