Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Appeals RN - MassHealth (Remote in MA)

Crains Cleveland

Boston, MA
  • Remote job

Crains Cleveland is seeking a Clinical Appeals RN responsible for attending appeal hearings and defending MassHealth prior authorization decisions. The position offers the opportunity to telecommute and requires candidates to reside in Massachusetts. Ideal candidates will possess an Associate’s degree in Nursing, an unrestricted licensure in MA, and at least 3 years of Managed Care or clinical experience. Additional benefits include Paid Time Off, a 401(k) Savings Plan, and comprehensive medical plans. #J-18808-Ljbffr Crains Cleveland

Vacancy posted 23 hours ago
Similar jobs that could be interesting for youBased on the Appeals RN - MassHealth (Remote in MA) in Boston, MA vacancy
  • UnitedHealth Group is seeking a Clinical Appeals RN in Boston, MA. This role involves representing MassHealth at appeal hearings and defending prior authorization decisions. Candidates must have a nursing degree and an unrestricted RN license in Massachusetts. The position... 
    Remote job

    Registered Nurse

    Boston, MA
    23 hours ago
  • The University of Minnesota School of Nursing is hiring a Clinical Appeals RN to manage appeal hearings and defend MassHealth's prior authorization decisions. This role requires individuals who reside in Massachusetts, with an opportunity to telecommute. Key qualifications... 
    Remote job
    Flexible hours

    University of Minnesota School of Nursing

    Boston, MA
    4 days ago
  • Stryker Corporation is looking for a Clinical Appeals RN in Massachusetts to represent MassHealth at appeal hearings and defend prior authorization decisions. The ideal candidate will have clinical experience, an RN license, and strong communication and time management... 
    Remote job

    Stryker Corporation

    Boston, MA
    23 hours ago
  • $28.94 - $51.83 per hour

    Texas Health Institute is hiring a Clinical Appeals RN to represent MassHealth at appeal hearings and perform clinical coverage reviews. The successful candidate must have an unrestricted RN license in Massachusetts and at least 3 years of managed care or clinical experience... 
    Remote job
    Hourly pay

    Texas Health Institute

    Boston, MA
    23 hours ago
  • $2,163 per week

     ...Registered Nurse (RN) | Neonatal Intensive Care Unit Location: Worcester, MA Agency: Atlas MedStaff Pay: $2,163 per week Shift Information: Nights...  ...either since a lot of our team has been working remote since the pandemic), but you are part of the Atlas... 
    Remote work
    Hourly pay
    Full time
    Contract work
    Work at office
    Shift work
    Night shift
    Weekend work

    TravelNurseSource

    Worcester, MA
    14 days ago
  • $52 per hour

     ...Hiring for RN - Appeals (Remote Role) in Somerville, MA Shift: Days 5x8 (08:00 - 17:00) Duration: 13 Weeks (Temp to Perm) Pay Rate: $52/hr on W2 ($2,080/WK) OT: $78/hr after 40hrs weekly Requirements: ~ MA RN License, BLS (AHA) ~100% remote ~ Looking for... 
    Remote job
    Permanent employment
    Temporary work
    Shift work

    Pacer Group

    Somerville, MA
    3 days ago
  • $28.94 - $51.83 per hour

    Clinical Appeals RN Clinical Appeals RN is responsible for attending appeal hearings, defending MassHealth prior authorization decisions, and performing pre-service/prior authorization...  ...of care and best practices Represent the MA MLTSS program in a positive, solution-... 
    Remote work
    Hourly pay
    Minimum wage
    Full time
    Temporary work
    Work experience placement
    Work at office
    Local area

    Stryker Corporation

    Boston, MA
    23 hours ago
  • $1,910 per week

     ...Registered Nurse (RN) | Intensive Care Unit (ICU) / Critical Care Location: Boston, MA Agency: Atlas MedStaff Pay: $1,910 per week Shift Information...  ...either since a lot of our team has been working remote since the pandemic), but you are part of the Atlas... 
    Remote work
    Hourly pay
    Full time
    Contract work
    Work at office
    Shift work
    Night shift
    Weekend work

    TravelNurseSource

    Boston, MA
    22 days ago
  •  ...coordinating clinical charge audits and appeal processes. The role demands strong analytical...  ...and quality assurance. This is a remote position requiring effective communication...  ...possess a Bachelor's Degree in Nursing, an MA State RN License, and have experience in appeal... 
    Remote job

    Mass General Brigham Incorporated.

    Somerville, MA
    1 day ago
  •  ...such as licensed vocational nurses (LVNs). Finally, we're open to remote providers who don't live in Austin, TX. About Us Modern...  ...Must have experience in a pediatrics practice as a triage nurse or MA. High level of emotional intelligence and an empathy-first approach... 
    Remote work
    Hourly pay
    Live in
    Weekend work
    Afternoon shift
    Weekday work

    Modern Pediatrics

    United States
    3 days ago
  • $95k - $110k

     ...DRG Nurse Reviewer Appeals and Hearings- Remote It takes great medical minds to create powerful solutions that solve some of healthcare's most...  ...guidelines; successfully completes required CEUs to maintain RN license and/or coding certification. Responsible for attending... 
    Remote work
    Full time
    Work from home
    Relocation package
    Flexible hours

    Gainwell Technologies

    United States
    23 hours ago
  • A healthcare service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and clinical case resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist license. Responsibilities include developing cases, researching... 
    Remote job

    Healthfirst

    New York, NY
    4 days ago
  • $29 - $52 per hour

    UnitedHealth Group is seeking a Remote Registered Nurse (RN) in California to handle appeals and medical record reviews. The ideal candidate should possess a current RN license and have at least 2 years of clinical experience. This role also requires familiarity with Medicare... 
    Remote job
    Hourly pay

    Council of State and Territorial Epidemiologists

    Cypress, CA
    23 hours ago
  • $2,938 per week

     ...Registered Nurse (RN) | Emergency Room (ER) / Trauma Location: Burlington, MA Agency: Seven Healthcare Pay: $2,938 per week Shift Information:...  ..., Burlington combines convenience with lifestyle appeal. Why Work with Seven Healthcare?... 
    Weekly pay
    Full time
    Local area
    Immediate start
    Flexible hours
    Shift work
    Night shift
    Weekend work

    Seven Healthcare

    Burlington, MA
    4 days ago
  •  ...values Every. Single. Day. We are currently seeking a CLINIC RN, LPN, or MA in Houghton, Michigan to work in our Houghton Clinic....  ...vaccination as a condition of employment. Staff at any work site or remote location, regardless of clinical responsibility or patient... 
    Remote work
    Full time
    Part time

    Aspirus Health

    Houghton, MI
    23 hours ago
  • $2,938 per week

     ...Registered Nurse (RN) | Emergency Room (ER) / Trauma Location: Burlington, MA Agency: Seven Healthcare Pay: $2,938 per week Shift Information:...  ..., Burlington combines convenience with lifestyle appeal. Why Work with Seven Healthcare?... 
    Weekly pay
    Full time
    Local area
    Immediate start
    Flexible hours
    Shift work
    Night shift
    Weekend work

    TravelNurseSource

    Burlington, MA
    4 days ago
  • $76.5k - $103.5k

    Cambia Health Solutions is looking for an Appeals Clinician I, focusing on resolving member appeals with your clinical expertise. You will...  ...should have a Bachelor's Degree in Nursing along with an active RN license. The role offers a competitive salary, with the expected... 
    Remote job
    Work from home
    Flexible hours

    Cambia Health Solutions

    Beaverton, OR
    4 days ago
  • Cambia Health Solutions is looking for an Appeals Clinician I to join their Clinical Services team. This role focuses on ensuring compliance with medical policy through clinical appeal reviews. Ideal candidates will have a Bachelor's Degree in Nursing and essential clinical... 
    Remote job
    Work from home

    Cambia Health Solutions

    Tacoma, WA
    4 days ago
  •  ...re looking for a passionate Registered Nurse to join our team as a RN Case Manager. This role will report into the Director of Nursing...  ...the Northern Massachusetts Area, specifically Fitchburg/Leominster, MA. The RN Case Manager at Abby Care provides the comprehensive... 
    Remote work
    Full time
    Relocation package
    Flexible hours
    Night shift
    Weekend work
    Weekday work

    Abby Care

    United States
    3 days ago
  • $29 - $52 per hour

    UnitedHealth Group is seeking a Clinical RN to conduct appeals assessment and care reviews. This role offers the flexibility to work remotely, adhering to Eastern or Central Standard Time. Candidates must have valid RN licensure and at least 2 years of clinical experience... 
    Remote job
    Hourly pay

    Stryker Corporation

    Cypress, CA
    1 day ago
  • $88.85k

     ...Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position...  ...work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in critical... 
    Remote work
    Full time
    Shift work
    Weekend work

    LOS Angeles Care Health Plan

    Los Angeles, CA
    3 days ago
  • $90k - $99k

     ...healthcare solutions provider seeks a DRG Nurse Reviewer Appeals and Hearings to coordinate appeal duties and engage...  ...virtual and on-site. Candidates must have an active RN license and coding certification. This remote role offers flexibility and opportunities for career... 
    Remote job
    Flexible hours

    Gainwell Technologies

    Florida, NY
    2 days ago
  • $36.75 per hour

    Position: PRN - Nursing (RN, LPN, CNA, MA) Location: Moab, UT Remote Status: On-Site Job Id: 230 # of Openings: 10 PER DIEM (PRN) - CLINICAL This is a great opportunity to work where you play! You are a qualified clinical professional seeking an opportunity to work... 
    Remote work
    Daily paid
    Full time
    Apprenticeship
    Casual work
    Relief
    Live in
    Local area
    Shift work

    Moab Regional Hospital

    Moab, UT
    3 days ago
  •  ...Appeals Processor III - RN ~ salary ~ Unavailable ~ Hours per week ~40 ~ Shifts ~5/8's ~ Start Date ~ Unavailable ~ Duration...  ...Appeals Processor III (APP III) to join our dedicated team in a remote capacity. The Appeals Processor III (APP III) is... 
    Remote work
    Contract work
    For contractors
    For subcontractor
    Shift work

    Ghost RX

    Orlando, FL
    2 days ago
  • $29 - $52 per hour

    Texas Health Institute is seeking a motivated RN to assess appeals and medical records, ensuring coverage and billable criteria. This role offers remote work flexibility, primarily within EST and CST hours. The candidate should have a valid RN license, 2+ years of clinical... 
    Remote job
    Hourly pay

    Texas Health Institute

    Cypress, CA
    23 hours ago
  • $66k - $68k

    WPS—A health solutions company is seeking an Appeals Nurse to examine medical records and claims for first-level appeal cases. This role...  ...salary range of $66,000-$68,000 depending on experience, with remote work options available in several states. Excellent... 
    Remote job

    WPS—A health solutions company

    Florida, NY
    4 days ago
  • Cambia Health Solutions is seeking an Appeals Clinician I to leverage clinical expertise in...  ...ensuring compliance with medical policies. This remote position is open to candidates residing in...  ...a Bachelor's Degree in Nursing, an active RN license, and at least 3 years of clinical... 
    Remote job

    Cambia Health Solutions

    Bellevue, WA
    4 days ago
  • HealthEdge is seeking an experienced clinical professional to manage appeals and grievances in a remote setting. The role involves investigating requests from members and providers and ensuring compliance with regulations. This position requires a Bachelor's degree, a... 
    Remote job

    HealthEdge

    New York, NY
    23 hours ago
  • The Elevance Health Companies, Inc. is seeking a Nurse Appeals RN-Quality of Care based in Metairie, Louisiana. The role involves investigating medical necessity appeals and reviewing member grievances to ensure timely resolutions. Applicants must have a current RN license... 
    Remote job
    Full time

    The Elevance Health Companies, Inc.

    Metairie, LA
    1 day ago
  • $90k - $105k

    Registered Nurse (RN) Care Manager - Hybrid job at Great Bay Staffing Group. Boston, MA. Make a Difference in Home-Based Care While Enjoying Flexibility and Work-Life...  ...needs through a blend of in‑home visits and remote coaching. This full‑time opportunity offers a competitive... 
    Remote work
    Full time
    Local area
    Relocation package
    Flexible hours
    Shift work
    Weekend work

    Great Bay Staffing Group

    Boston, MA
    4 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Appeals RN - MassHealth (Remote in MA). Be the first to apply!