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AdventHealth Logo
Registered Nurse RN Case Manager
AdventHealth

Orlando, Florida

NEW!
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Nurse Practitioner or Physicians Associate - Part Time
Optum

Portland, Oregon

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HEDIS Quality Consultant LVN In Office Austin Texas
Optum

Austin, Texas

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Full-time HouseCalls Nurse Practitioner - Dallas and Kaufman Counties, TX
Optum

Kaufman, Texas

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Baylor Scott & White Health Logo
Care Manager RN
Baylor Scott & White Health

Anderson Mill, Texas

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Optum Logo
Statewide Traveler Nurse Practitioner or Physician Assistant, Housecalls - WI
Optum

Milwaukee, Wisconsin

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Nurse Practitioner -HouseCalls- Dual Statewide Traveler - ME & NH
Optum

Portland, Maine

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Spartanburg Regional Healthcare System Logo
Physician - Trauma and Critical Care Surgeon
Spartanburg Regional Healthcare System

Spartanburg, South Carolina

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Optum Logo
HouseCalls Nurse Practitioner - North Dakota Statewide Traveler
Optum

Fargo, North Dakota

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Harris Health System Logo
Behavioral Health Medical Director
Harris Health System

Houston, Texas

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Optum Logo
Nurse Practitioner or Physicians Assistant - Part Time
Optum

Eugene, Oregon

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AdventHealth Logo
Registered Nurse Emergency Department Nights
AdventHealth

Ocala, Florida

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Baylor Scott & White Health Logo
Care Manager RN
Baylor Scott & White Health

Leander, Texas

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AdventHealth Logo
Registered Nurse ICU Neonatal Nights
AdventHealth

Ocala, Florida

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Psychiatrist
WMCHealth

Suffern, New York

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Baylor Scott & White Health Logo
Care Manager RN
Baylor Scott & White Health

Austin, Texas

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Baylor Scott & White Health Logo
Care Manager RN
Baylor Scott & White Health

Pflugerville, Texas

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University of Maryland Medical System Logo
CASE MANAGER
University of Maryland Medical System

Baltimore, Maryland

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Optum Logo
Nurse Practitioner Housecalls Pulaski, Wayne, Russell - KY
Optum

Somerset, Kentucky

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University of Maryland Medical System Logo
Surgical Coordinator, Robotics, OR
University of Maryland Medical System

Largo, Maryland

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Vanderbilt Health Logo
VIPMS Gallatin Staff Nurse - CMA, LPN, or RN
Vanderbilt Health

Nashville, Tennessee

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PIH Health Logo
Ambulatory Case Manager, LVN, Resource Pool, Hybrid
PIH Health

Whittier, California

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Optum Logo
Physician Assistant or Nurse Practitioner - Warren Washington Counties
Optum

Glens Falls, New York

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AdventHealth Logo
Registered Nurse RN Case Manager Home Care
AdventHealth

Orlando, Florida

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WMCHealth Logo
Director and Chair, Otolaryngology
WMCHealth

Valhalla, New York

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Appeals and Grievance Nurse Registered Nurse II PRN
DescriptionSummary:Responsible for the management and communication of denials/appeals received from third party payers, managed care companies, and/or government entities/auditors related to medical necessity and/or level of care. This associate will be a liaison and point of contact for clinical denials and appeal inquiries. The Clinical Appeals Nurse will review each case identified/referred for appeal based on Milliman Care Guidelines (MCG), InterQual, and/or other relevant guidelines, determined the viability of the appeal, and manage the appeal process. The Clinical Appeals Nurse is responsible for appealing all inappropriate denials through all possible levels of the appeal process. The RN Clinical Appeals Nurse will actively manage, maintain an


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