Remote Medicare Appeals Nurse Consultant
CVS
Denver, CO
- Remote job
CVS Health in Colorado is seeking an Appeals Nurse Consultant to assess the medical necessity of Medicare Part C appeals for members and providers. This production role requires evaluating requests, researching guidelines, and using several computer systems while working remotely. The position requires an active RN license, strong communication and organizational skills, and an Associate's Degree in Nursing. 40 hours weekly with weekend/holiday rotation and a comprehensive benefits package. #J-18808-Ljbffr CVS Health
Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Remote Medicare Appeals Nurse Consultant in Denver, CO vacancy
- CVS Health is seeking an Appeals Nurse Consultant to process Medicare Part C appeal requests from members and providers. The role is production-based and remote, with a 40-hour work week and occasional weekend/holiday rotations. Qualified candidates hold an RN license,...Remote job
- CVS Health is recruiting an Appeals Nurse Consultant to process medical necessity for Medicare Part C appeals. The role combines independent and team work in a remote setting, with a 40-hour weekly schedule and occasional weekend/holiday rotations. Required RN licensure...Remote job
$54.1k - $142.58k
CVS Health's Appeals Nurse Consultant role is a full-time, remote-friendly position focused on evaluating Medicare Part C appeals. The job requires an active RN license, strong communication, and solid organizational skills, with a 40-hour workweek and weekend/holiday rotation...Remote jobFull timeWeekend work- CVS Health in the United States is seeking an Appeals Nurse Consultant to evaluate Medicare Part C medical necessity for members and providers. This role... ...blends independent action with team collaboration in a remote setting. The position features a 40-hour work week, weekend...Remote jobWeekend work
- CVS Health is seeking an Appeals Nurse Consultant to review and determine medical necessity for Medicare Part C appeals from members and providers. This production role requires... ..., and the ability to work independently in a remote, fast-paced environment. Typical schedule...Remote jobWeekend work
- CVS Health in Idaho is seeking an Appeals Nurse Consultant to process the medical necessity of Medicare Part C appeals. This full-time role requires an active RN license... ...on safe, quality care. The role supports remote work within the U.S. time zones. #J-18808-Ljbffr...Remote jobFull timeWeekend work
- CVS Health is seeking an Appeals Nurse Consultant to evaluate medical necessity for Medicare Part C appeals. The role requires an active RN license, strong communication... ...include independent and team collaboration in a remote setting, handling multiple systems, and...Remote jobFull time
- CVS Health is seeking an Appeals Nurse Consultant to process Medicare Part C appeals. The role is full-time (40 hours/week) with a Monday shift of 8am-4:... ...rotation of weekends/holidays. The position supports a remote, team-driven environment in a fast-paced clinic...Remote jobFull timeShift workWeekend work
$66.58k - $142.58k
...health care one person, one family and one community at a time. Position Summary CVS Aetna is seeking a dedicated Appeals Nurse Consultant to join our remote team. Key Responsibilities Responsible for the review and resolution of clinical appeals. Reviews documentation...Remote workHourly payWeekly payFull timeTemporary workWork experience placementLocal areaMonday to FridayShift work$54.1k - $142.58k
...CVS Health Nurse Appeal Consultant We're building a world of health around every individual shaping... ...processing the medical necessity of Medicare Part C appeals from both members and providers... ...in a team environment while working remotely. The Medicare Clinical Appeals Team C...Remote workFull timeLocal areaShift workWeekend work- CVS Health Corporation's CVS Aetna unit is seeking a dedicated Appeals Nurse Consultant to join our remote team. This full-time role offers a 40-hour workweek and remote flexibility, with occasional on-call coverage to support clinical appeals. Requirements include an active...Remote jobFull time
- CVS Health is seeking a Utilization Management Nurse Consultant (Clinical Precertification RN, Medicare) to review clinical cases and determine coverage using evidence-based guidelines in a remote, full-time weekday schedule. You will collaborate with providers and care...Remote jobFull timeWeekday work
- Apolis is seeking a Grievance and Appeals RN in Phoenix, AZ (or remote within AZ time zone) to review and investigate member and provider grievances and appeals for Medicare Part C and Part D. The nurse reviews medical records, claims, authorizations, and plan benefits...Remote job
- ...Role Snapshot The Appeals Nurse examines medical records and claims information for first-... ...provided were medically necessary and meet Medicare coverage guidelines in accordance with... ...experience. Work Location We are open to remote work in the following approved states:...Remote workContract workFor contractorsLocal areaImmediate start
WPS Health Solutions
Columbus, OH2 days ago - WPS Health Solutions in Columbus, OH, is seeking an Appeals Nurse to review medical records and Medicare claims for first-level appeals to determine medical necessity and coverage alignment. The role collaborates with Appeals Examiners to prepare timely redeterminations...Remote job
- ...Regional MDS / PDPM / CMI / RAI Consultant Are you ready to make a... .../ RAI Consultant to provide remote reimbursement, MDS, PDPM, Case... ...our long-term care and skilled nursing facilities. This position... ..., CMI, care planning, Medicare documentation, and long-term...Remote workHourly payLocal areaNight shift
Prestige Healthcare Management
United States3 days ago - ...experienced Regional MDS / PDPM / CMI / RAI Consultant to provide remote reimbursement, MDS, PDPM, Case Mix... ...to our long-term care and skilled nursing facilities.This position will provide... ...RAI guidelines, CMI, care planning, Medicare documentation, and long-term care reimbursement...Remote workHourly payLocal areaNight shift
Elite Nursing and Rehabilitation Center
West Des Moines, IA3 days ago - ...the encoding and electronic submission of MDS, RUGS, Medicare, Medicaid, and OBRA documentation. Review nursing notes to ensure clarity, accuracy, and alignment... ...Competitive pay and travel opportunities. Hybrid schedule (remote and on-site). Supportive, collaborative team...Remote workFull timeContract work
AHI - Advanced Health Institute
Minneapolis, MN8 hours ago $27.5 per hour
...Job Title Pay Rate: $27.50 per hour Work Mode: Fully Remote Duration: September to February with possible extension Responsibilities... ...: Minimum of 3 years of experience in clinical nursing, working with an adult population. Must possess excellent verbal...Remote workHourly payAxelon
United States1 day ago- ...IMCS Group is seeking an experienced nurse for a 10-month contract role primarily focused on reviewing clinical data and managing member appeal requests in accordance with company policies. The position allows for remote work, preferably from Iowa, with possible on-site...Remote workContract work
IMCS Group
West Des Moines, IA4 days ago $95k - $105k
...Nurse Consultant Polaris Group, the SNF Clinical branch of Assembly Health, is seeking a dynamic, client-focused Nurse Consultant. We are... ...who stays current on federal and state regulations, Medicare requirements, MDS standards, reimbursement systems, and best...Remote workFull timeWork at officeAssembly Health
United States4 days ago$62.04k - $102.37k
...Nurse Consultant I (NS) The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies... ...be a licensed registered nurse. This Position Is A Fully Remote Work Option This Is A Home-Based Position In The Central/Eastern...Remote workWork experience placementLocal areaNight shiftNorth Carolina
United States5 days ago- CVS Health seeks a NICU Utilization Management Nurse Consultant to support high-risk neonatal populations through clinical review, care coordination, and evidence-based decision-making. This remote role requires an active RN license, NICU nursing experience, and familiarity...Remote jobWork from home
- ...Overview Job Title: Registered Nurse – Claims & Appeals Review Location: Remote (Anywhere in Florida) Duration: 06 Months/Can be Extended Working hours: Day Shift Job Type: Subcon Pay Rate: Negotiable Position Description The Quality Analyst...Remote workContract workDay shift
Compunnel
Florida, NY4 days ago - ...support utilization management and prior authorization from a remote setting. You will review requests, determine medical necessity,... ...members. Required are an active multi-state RN license, 3+ years nursing, and 2+ years in UM or similar. Proficiency with InterQual/MCG...Remote job
- CVS Health is seeking a NICU Utilization Management Nurse Consultant to support high-risk neonatal populations. The role involves clinical... ...care coordination, and evidence-based decision-making across remote settings. You will collaborate with neonatologists, hospitals...Remote job
- Walker Healthforce, LLC seeks a Medical Claim Review Nurse for a fully remote contract based in Washington. The role focuses on retrospective medical necessity reviews, appeals, and payment integrity within Molina Healthcare of Washington. The ideal candidate holds an active...Remote jobContract work
- ...Health and Human Services (DHHS) Immunization Branch is seeking a Nurse Consultant II to provide advanced clinical guidance, supervise field... ...federally funded position offers the possibility of a fully remote work option, with responsibilities including site visits, #J...Remote jobPrivate practiceLocal area
- MaziCTools is seeking a Freelance Utilization Management Nurse Consultant to work remotely in the United States. This full-time role requires an active RN licensure and 3+ years of clinical experience. Responsibilities include assessing healthcare services, communicating...Remote jobFull timeFreelanceWork at officeMonday to FridayWeekend work
- Solü Technology Partners is seeking a Med Appeals & Grievance Specialist Coordinator (... ...prior authorizations. Must be a licensed nurse with strong clinical and analytical skills... ...coordinating with internal departments. Remote work is available; schedule 8:00-4:30 Mountain...Remote jobContract work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Medicare Appeals Nurse Consultant. Be the first to apply!
Related searches
- epic consultant part time Denver, CO
- lighting consultant Denver, CO
- process improvement consultant Denver, CO
- accenture consultant Denver, CO
- event consultant Denver, CO
- statistical consultant Denver, CO
- spa consultants Denver, CO
- diversity consultant Denver, CO
- short term consultant Denver, CO
- hospitality consultant Denver, CO