Remote RN: Medicaid Appeals Clinical Coordinator
UnitedHealth Group
UnitedHealth Group is seeking an HSS Clinical Coordinator RN to conduct clinical reviews and evaluations related to Medicaid appeals, ensuring compliance and accuracy in assessments. This remote role is ideal for experienced RNs seeking meaningful patient-care impact.
You will review medical records, identify discrepancies, provide clinical judgment on medical necessity, and document findings. The position is full-time, daytime, with residency in Texas required.
#J-18808-Ljbffr- ...Clinical Coordinator Under the general direction of the Associate Director... ...respond to inquiries related to appeals following clinical... ...equivalent experience required OR RN licensed to practice in Massachusetts... ...Working Conditions Remote/desk work with- some...Remote workWork experience placementWork at office
$29 - $52 per hour
...have the flexibility to work remotely* as you take on some tough challenges... ...: Conduct comprehensive clinical reviews of appealed H6516 and H2060 assessment... ...~ Current unrestricted Texas RN license ~2+ years of experience working in Medicaid ~2+ years of experience...Remote workHourly payMinimum wageFull timeWork experience placementLocal areaWork from homeMonday to Friday$29 - $52 per hour
...have the flexibility to work remote* as you take on some tough challenges... ..., and state resources Coordinate care across the continuum and... ...~ Current unrestricted Texas RN license ~2+ years of... ...Qualifications: Experience with Medicaid, LTSS, or long-term care...Remote workHourly payMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- ...Centene Corporation is seeking a Remote Appeals Liaison to act as the statewide liaison for appeals, fair hearings, and review organizations... ...include preparing reviews, generating compliant letters, coordinating with Medical Directors, and maintaining NCQA/state...Remote work
$52 per hour
...Hiring for RN - Appeals (Remote Role) in Somerville, MAShift: Days 5x8 (08:00 - 17:00) Duration: 13 Weeks (Temp to Perm)Pay Rate: $52/hr on... ...for a registered nurse with payor experience (Commercial and Medicaid)Would like to have at least 2 years of Health Plan appeals experienceWorks...Remote workPermanent employmentTemporary work$69.72k - $104.58k
...Roanoke Requisition Number: R162761 Clinical Coordinator RN - EM Follow Up - Roanoke (Open) How... ...in the Emergency Department with 1 day remote. The Clinical Coordinator Utilizes... ...job functions. Knowledge of Medicare Medicaid and other third-party payor regulations...Remote workFull timeWork experience placementMonday to FridayShift work- ...Appeals Processor III - RN ~ salary ~ Unavailable ~ Hours per week ~40... ...join our dedicated team in a remote capacity. The Appeals Processor... ...appeals related to Medicaid or Medicare coverage decisions... ...reviewing medical documentation (clinical roles may require RN)...Remote workContract workFor contractorsFor subcontractorShift work
$70.12k - $126.19k
...liaison for all statewide appeals, fair hearings, review... ...Details: This is a remote position. Hours are Monday... ...preferred. Review clinical information for all appeals... ...and NCQA standards. Coordinate with Medical Director(s... .../Experience: RN with 4+ years of clinical...Remote workHourly payFull timePart timeWork at officeMonday to FridayFlexible hours- ...Phaxis is looking for a dedicated Remote RN Grievance and Appeals Specialist in Manhattan where your contributions... ...impact on patient care and overall clinic operations. We are looking for a... ...Requirements Medicare and Medicaid experience preferred Strong backgrounds...Remote workPermanent employmentContract workTemporary workMonday to Friday
- ...Description Job Description LTSS Appeals Nurse (Remote) We are seeking a detail-... ...will perform high-volume clinical reviews within the appeals... ...York Registered Nurse (NY RN) license. Residency:... ...CDPAP). Prior experience in Medicaid managed care, health plans,...Remote workLocal areaMonday to FridayFlexible hoursShift work
- ...MES Solutions is seeking a self-driven RN or LPN to join our team as a Clinical Quality Assurance Coordinator. This 100% remote role focuses on quality review of peer review reports, ensuring evidence-based rationales, and compliance with client agreements and regulatory...Remote work
- ...UnitedHealth Group is seeking a Field Based HSS Clinical Coordinator RN in Bexar County, TX. The role involves coordinating care, connecting... ..., and advocating for patient needs. Flexibility to work remotely is available within the territory; travel is expected up to...Remote work
- ...UnitedHealthcare in Harlingen, TX is seeking an RN to assess, plan, and implement person-centered strategies while coordinating care across the continuum and advocating for members. The role offers remote work flexibility within a defined territory and requires travel...Remote work
- ...UnitedHealth Group is seeking a Field Based HSS Clinical Coordinator RN in Harris County, TX. This role offers flexible remote work for those in the greater Houston area, with travel to the Houston region required up to 50% of the time. You will assess, plan, and implement...Remote workFlexible hours
- ...UnitedHealth Group is seeking a Field Based HSS Clinical Coordinator RN in the Weslaco/Hidalgo, TX area. This role offers the flexibility to work remotely from within commuting distance and requires coordinating care, connecting members to resources, and advocating for...Remote work
$29 - $52 per hour
...have the flexibility to work remotely* as you take on some tough challenges... ..., and state resources Coordinate care across the continuum and... ...~ Current unrestricted Texas RN license ~2+ years of... ...Qualifications: Experience with Medicaid, LTSS, or long-term care...Remote workHourly payMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- 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 work
$29 - $52 per hour
...health-related information to ensure quality coordinated care and services are provided... ...Qualifications: ~ Current unrestricted Texas RN license ~2+ years of experience in a community... ...up to 75% in assigned region to visit Medicaid members in their homes and/or other...Remote workHourly payMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$40 - $46 per hour
...immediately hiring for a RN Clinical Appeals Specialist Position type... ...Location: Philadelphia PA 19103 (Remote) As a RN Clinical... ...research matched-specialty coordination determination support notification... .... Knowledge of Medicare Medicaid Commercial Exchange ERISA...Remote workHourly payFull timeContract workTemporary workFor contractorsWork experience placementWork at officeImmediate startWorldwideFlexible hours- ...Join to apply for the Clinical Coordinator - LPN or RN role at Paradigm 2 days ago Be among the first 25 applicants Join to apply for the Clinical... ...introduction to Paradigm. We are seeking a full-time remote Clinical Coordinator (LPN or RN). The position is...Remote workFull timePart timeFor contractorsReliefLive inLocal areaMonday to FridayFlexible hoursWeekend work
- ...Clinical Coordinator, RN - EM Follow Up - Franklin (Open) This position is working full time, daytime hours and occasional weekends. This is... ...in Rocky Mount, VA in the Emergency Department with 1 day remote. The Clinical Coordinator uses advanced nursing processes in...Remote workFull timeWork at office
$29 - $52 per hour
...have the flexibility to work remotely as you take on some tough challenges... ...to ensure quality coordinated care and services are provided... ...~ Current unrestricted Texas RN license ~2+ years of experience... ...: Experience with Medicaid, LTSS, or long-term care services...Remote workHourly payMinimum wageFull timeWork experience placementWork at officeLocal areaFlexible hours$16.88 - $33.22 per hour
...Clinical Administrative Coordinator - National Remote Clinical Administrative Coordinator - National Remote 1 week... ...Responsibilities Review incoming Appeal emails and processing the request... ...working with Medicare and/or Medicaid Services Experience in a hospital...Remote workHourly payMinimum wageFull timeWork experience placementLive inWork at officeLocal areaShift work- ...Vaya Health is seeking a Registered Nurse to provide needs-based PCS assessments for Medicaid beneficiaries in North Carolina, primarily in Alamance, Chatham, and Caswell counties. The role requires residence in NC or within 40 miles of the NC border and travel to counties...Remote work
- ...Nurse to perform needs-based assessments for Medicaid Personal Care Services in NC. You will... ...PCS providers. The role requires NC RN licensure, a healthcare background, and the... ...Alamance, Chatham, and Caswell counties. Remote work with NC residency is required and...Remote work
- ...seeking a Registered Nurse to perform needs-based assessments for Medicaid Personal Care Services in NC communities. You will schedule... ...process SARs with PCS providers. Applicants must hold an active NC RN license, have a BSN or healthcare degree, and be able to travel...Remote work
$80k
...about us: Are you searching for your next non-clinical RN opportunity? Join our team- We are hiring an RN Clinical Coordinator (Nursing Clinical Coordinator) to lead and... ...Days Schedule: Hybrid, 4 days in-person, 1 day remote Location: Orlando, FL. Salary: $85-$90K per...Remote workPermanent employmentLocal areaMonday to FridayFlexible hours- ...UnitedHealthcare is hiring a Field Based HSS Clinical Coordinator RN in the College Station/Bryan, TX area. This remote-friendly role coordinates care, connects members to resources, and advocates for patient-centered plans within the assigned territory. Required are...Remote workHourly payFlexible hours
- ...seeking a Registered Nurse to perform needs-based assessments for Medicaid beneficiaries applying for State Plan Personal Care Services in... .... Requirements include a Bachelor's degree in Nursing or related field, active RN licensure in NC, two #J-18808-LjbffrRemote work
- ...LPN – Clinical Quality & Care Coordinator Work Location: Brooklyn, NY 11218 Work Setting: Onsite (Monday – Thursday, Friday Remote) Work hours: 9AM -5PM EST Work Type: Temporary Role (3... ...As part of New York State’s 1115 Medicaid Waiver, NSIPA plays a key role in...Remote workFull timeTemporary workWork at officeMonday to Friday
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