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
Appeals and Grievances Clinical Specialist - RN or LPN
A company is looking for an Appeals and Grievances Clinical Specialist - RN or LPN, 100% Remote. ...
Clinical Specialist Pharmacist / Inpatient and Outpatient Hematology Float
Environmental exposures include, but are not limited to: Blood-borne pathogen exposure; Bio-hazardous waste Chemicals/gases/fumes/vapors; Communicable diseases; Electrical shock; Floor Surfaces; Hot/Cold Temperatures; Indoor/Outdoor conditions; Latex; Lighting; Patient care/handling injuries; Radiat...
Complaints and Grievances Specialist
A company is looking for a Complaints & Grievances Specialist II to handle investigations and resolutions of complaints and grievances. ...
Paramedic OR Nurse - LPN, LVN or RN.
This includes explanation of procedures, hazards and potential adverse events; explanation of immunization schedules, dose and antibody response; providing clear opportunity for donor to refuse participation; obtaining signature and date certifying informed consent. In conjunction with the Center Me...
Clinical Appeals Specialist RN
A company is looking for a Clinical Appeals Specialist RN (Remote). ...
Clinical Liaison (RN or RT)
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 ...
Care Transition Coordinator - 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...
Travel Nurse RN - OR - $1,688 per week in Marietta, GA
Health Carousel Nursing and Allied Health is seeking a qualified. ...
Nurse Substitute (RN and LPN) (Supply Employees) 2024-2025
The DeKalb County School District is an equal opportunity employer, and all hiring decisions are subject to federal, state, and local employment laws and regulations. Under direct supervision, provides appropriate health/medical services to designated students in an effort to minimize absences due t...
Regional Program Director - Home Health Sales RN, LPN, PT, OT, SLP
Must be able to utilize reports and trends to support efforts and to understand clinical status and progress. The Community Care Regional Program Director will monitor execution of the community care program and service provision through ongoing quality assurance visits with referral sources and wor...