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Job Summary The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies...

Why ThedaCare? Living A Life Inspired! Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion to provide outstanding care. We are inspired to reinvent health care by becoming a proactive partner in...

Location Address: 1100 Central Avenue SE , Albuquerque, New Mexico 87106-4930, United States of America Compensation Pay Range: Minimum Offer $: 34.68 Maximum Offer for this position is up to...

Serious Medicine is what we do. Being extraordinary is who we are. Every colleague plays a key role in upholding this promise to our patients and their families. Shift: First Shift (United States of America)...

If you are looking to make an impact on a meaningful scale, come join us as we embrace the Power of One! We strive to be an employer of choice and establish a reputation for being a talent rich organization where Associates can grow...

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families,...

Care Manager Sharecare is the leading digital health company that helps people unify and manage all their health in one place. Our comprehensive and data-driven virtual health platform is designed to help people, providers, employers,...

A healthcare organization is looking for a Preservice Review Nurse RN in Boston, Massachusetts. The role involves performing pre-service clinical coverage reviews for Home Health services, ensuring patient access to appropriate care. Successful...

Why is Health Advocate a great place to work? For starters, Health Advocate employees enjoy helping people every single day. Employees are given the training they need to do their jobs well, and they work with supervisors and staff who are...

Explore Opportunities With Agency Name As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each...

Job Profile Summary Position Purpose: nalyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's...

Dept: Quality and Provider Ed ****Looking for a registered nurse in the Grand Rapids or northern Michigan (lower peninsula) area. Most work will be remote from home and/or traveling, however, there are occasions contractor will need to...

Description The Appeals Nurse examines medical records and claims information for first-level appeal cases to determine whether services provided were medically necessary and meet Medicare coverage guidelines in accordance with Medicare...

Care Manager Sharecare is the leading digital health company that helps people no matter where they are in their health journey unify and manage all their health in one place. Our comprehensive and data-driven virtual health platform is...

Job Summary The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies...

Registered Nurse: Review and Evaluation Are you a registered nurse ready to take your career in an exciting new directionone where your expertise truly makes a difference? Join Pennsylvania's premier Quality Improvement Organization and...

Salary: $70,779.53 Annually Location : Homebased, GA Job Type: Full-Time Salaried Job Number: 2020-02252 Division: Healthcare Facility Regulation...

Where You'll Work St. Elizabeth Community Hospital provides state-of-the-art health care to the North State communities. This award-winning facility is a member of the Dignity Health system of health care providers and is a...

Description Location: UCHealth UCHlth Leprino Building AMC, US:CO:Aurora Department: CTRC Outpatient FTE: Full Time, 0.9, 72.00 hours per pay period (2 weeks) Shift: Days Pay: $33.61 - $52.10 / hour. Pay is dependent on applicant's relevant...

Day to Day Responsibilities Triage and review cases as needed, working on prior authorisation cases following medical policy utilizing resources as needed Required Skills (top 3 non-negotiables):...

Find your calling at Mercy! Serves as primary liaison between the doctor and patient. Responsible for communicating with patients, assessing and evaluating their needs and advising the patients of the recommended...

Discover. Achieve. Succeed. #BeHere Location: US:WI:MENOMONEE FALLS at our CP-NORTH HILLS HEALTH CENTER facility. This job is ON - SITE. FTE: 0.400000 Standard...

SUMMARY: Under the general supervision of the Nurse Manager (or designee), reporting to Pre-Admission Testing in Surgical Services and within hospital and departmental policies and procedures, the professional registered nurse acts as a...

You Belong Here. At MultiCare, we strive to offer a true sense of belonging for all our employees. Across our health care network, you will find a dynamic range of meaningful careers, opportunities for growth, safe workplaces, and...

Description At Bath & Body Works, everyone belongs. We are committed to creating a culture of belonging focused on delivering exceptional fragrances and experiences to our customers. We focus on recruiting, retaining, and...