Remote Weekend UM Nurse Lead for Medicare Appeals
Humana Inc
- Remote job
Humana Inc. in the United States is seeking a Part C G&A Nurse (Utilization Management Nurse 2) to support case preparation, review medical documentation and coordinate appeal determinations. This remote, full-time role requires an RN with a compact license, 3+ years of clinical experience, and strong MS Word/Outlook/Excel skills. Weekend team lead duties include inventory monitoring and guiding staff, with occasional travel to Humana offices and a 40-hour week. #J-18808-Ljbffr Humana Inc
- ...Health in the United States is seeking an Appeals Nurse Consultant to evaluate Medicare Part C medical necessity for members... ...independent action with team collaboration in a remote setting. The position features a 40-hour work week, weekend/holiday rotation, and a comprehensive...Remote jobWeekend work
- CVS Health is seeking an Appeals Nurse Consultant to process Medicare Part C appeals. The role is full-time (40 hours/week) with a... ...4:30pm in your time zone and a rotation of weekends/holidays. The position supports a remote, team-driven environment in a fast-paced clinic...Remote jobWeekend workFull timeShift work
- CVS Health is seeking an Appeals Nurse Consultant to review and determine medical necessity for Medicare Part C appeals from members and providers... ...to work independently in a remote, fast-paced environment.... ...40 hours per week with weekend/holiday rotation; benefits include...Remote jobWeekend work
- ...Health in Idaho is seeking an Appeals Nurse Consultant to process the medical necessity of Medicare Part C appeals. This full-time... ...offers a 40-hour schedule with weekend and holiday rotation,... ...quality care. The role supports remote work within the U.S. time zones...Remote jobWeekend workFull time
- ...Grievance & Appeals Coordinator Are you an analytical problem solver with a passion for... ...growing, collaborative team! In this fully remote role, you will analyze and resolve... ...flexibility of working from your home office on a steady schedule with weekend-free days....Remote workWeekend workWork from homeHome office
$60.78k
...Appeals and Grievances Specialist II Job Category: Customer Service Department... ...in compliance with Centers for Medicare and Medicaid Services (CMS), California... ...position requires work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in...Remote workWeekend workFull timeLocal areaShift work$40k - $52.3k
...Bilingual Telephonic UM Coordinator role... ..., Skilled Nursing Facilities and other... ...requests. Search for Medicare and Medicaid Guidelines... ...to work Nights, Weekends and Holidays based... ...: While this is a remote position,... ...These efforts are leading to a better quality...Remote workWeekend workBi-weekly payFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to FridayNight shift$19.76 per hour
...in Iowa? We are seeking a self-motivated, organized Grievance & Appeals Coordinator to join our dynamic team! In this essential role,... ...role offers an ideal platform to advance your career with zero weekend or on-call requirements. salary: $19.76 - $19.77 per hour...Remote workWeekend workHourly payPermanent employmentTemporary workWork experience placementWork at officeWork from homeHome officeMonday to FridayShift work- ...Specialist Insight Global is seeking a fully remote Denials Specialist to support a... ...candidates will leverage their denials and appeals expertise to evaluate and improve AI-driven... ...Monday-Friday, 9am-8pm PST (can't work weekends) (must be available 10-20 hours/week from...Remote workWeekend workContract workPart timeMonday to FridayFlexible hoursShift work
$22.99 per hour
...care? We are seeking dedicated Grievance & Appeals Coordinators to join our growing, collaborative team! In this fully remote role, you will analyze and resolve complex member... ...your home office on a steady schedule with weekend-free downtime. You will play a vital role in...Remote workWeekend workHourly payPermanent employmentTemporary workWork experience placementWork at officeWork from homeHome officeShift work- ...looking for a, Per Diem, Registered Nurse Team Leader (Triage) every other weekend, 4 days a month, to support our... ...This role is Office Based (no remote options) located in our Ventura... ...care in compliance with Title 22, Medicare, state licensure regulations, accreditation...Remote workWeekend workHourly payDaily paidWork experience placementWork at officeFlexible hoursShift workDay shiftAfternoon shift
- Montefiore Medical Center is seeking a Clinical Appeals Manager to lead the Wakefield Division's appeals process. You will respond to third-party... ...the tracking system, and perform first-level reviews for Medicare admissions. Strong medical-necessity knowledge and...
- ...Leader City Scottsdale State AZ Remote NO Why Mayo Clinic Mayo Clinic is top-... ...TL is accountable for the coordination of nursing care, including direct patient care,... ...include days, evenings, nights, holidays, and weekends and on-call. Current RN licensure by...Remote workWeekend workFlexible hoursNight shiftAfternoon shift
$248.5k - $373k
...enjoy the flexibility to work remotely * from anywhere within the U.S... ...rotation. Is available for periodic weekend and holiday coverage as needed... ...including physicians, nurses, PTs, OTs and other similar personnelWilling... ...in managed care UM activities/ coverage reviewsExperience...Remote workWeekend workMinimum wageWork experience placementLocal area- ...City Phoenix State AZ Remote NO Department Nursing Why Mayo Clinic Mayo Clinic is top-ranked in more specialties than any other... ...which may include days, evenings, nights, holidays, and weekends and on-call. Current RN licensure by applicable state...Remote workWeekend workFull timeFlexible hoursShift workNight shiftAfternoon shift
$71.1k - $97.8k
...The Part C Grievance & Appeals (G&A) Nurse (Utilization Management Nurse... ...to review by the Humana G&A Medicare Medical Directors. You will... ...Appeals (G&A) Nurse will be a Weekend Team Lead to support the Appeals team... ...rotation. This is a remote position. This role is responsible...Remote workWeekend workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeFlexible hoursWeekday work$236.5k
...with clinical teams, network providers, appeals team, medical and pharmacy consultants for... ...hoc committees. May be required to work weekends and holidays in support of business operations... ..., and a flexible approach to work with remote, hybrid, field or office work schedules....Remote jobWeekend workFull timePart timeWork at officeFlexible hours$248.5k - $373k
...enjoy the flexibility to work remotely * from anywhere within the U.S... ...rotation. Is available for periodic weekend and holiday coverage as needed... ...including physicians, nurses, PTs, OTs and other similar personnel... ...Experience in managed care UM activities/ coverage reviews...Remote jobWeekend workMinimum wageWork experience placementLocal area$128k - $160k
...Supervisor, Appeals Pharmacist Charlotte, North... ...Americans and proudly leading the next generation of... ...Commercial Exchange, FEHB, Medicare Part B&D, and Medicaid... ...on-call rotation for weekends, holidays, and after-... ...experience in a remote environment. This...Remote workWeekend workContract workWork at officeLocal areaMonday to FridayFlexible hoursShift work- ...Appeals Clinical Specialist The Appeals team oversees all operational and clinical aspects... ...or other company location (or from a remote location with management approval based on... ...one must have the ability to work nights, weekends or on holidays as required. This may be...Remote workWeekend workFull timeWork at officeLocal areaMonday to FridayNight shift
- ...to 5PM work-shifts. ~40 Weeks On-Site ~8 weekends per year (Saturday and Sunday), weekends are 100% Remote ~12-weeks of PTO per year. ~ Additional... ...to cutting edge technology. If our model appeals to you, please e-mail a cv (or if you have a...Remote workWeekend workFor contractorsRelocation packageMonday to FridayShift work
$34.42 - $67.6 per hour
Join to apply for the Appeals and Letters Coordinator Remote role at Optum 1 day ago Be among the first 25 applicants... ...in after-hours on-call rotation and weekend rotation for processing pre-service... ...in state of residence - Registered Nurse, Physical Therapist, Occupational...Remote jobWeekend workHourly payMinimum wageFull timeContract workPart timeWork experience placementWork at officeLocal areaShift work- ...Medical Officer, Chief Nursing and Operational... ...in Centers for Medicare and Medicaid Services... ...involved in remote utilization review... ...issues potentially leading to delivery of suboptimal... ...AM 4 PM plus one weekend (Saturday and... ...per the Lee Health UM Plan.2026/2027 Goals...Remote workWeekend workContract workFor contractorsMonday to Friday3 days per week
- ...deliver inpatient hepatology and outpatient GI care at UM hospital and affiliated clinics in Miami, FL. The role requires... ...participate in infusion services and research coordination. This is a non-remote, full-time position with weekend coverage as needed. #J-18808-Ljbffr...Remote workWeekend workFull time
$54.1k - $142.58k
...CVS Health Nurse Appeal Consultant We're building a world of health... ...time zone Rotation of weekend and holiday shifts, approximately... ...the medical necessity of Medicare Part C appeals from both members... ...environment while working remotely. The Medicare Clinical...Remote workWeekend workFull timeLocal areaShift work- ...Physician Advisor - UM MSQ - 161706 Tampa: St Josephs | Physician | Part Time Description... ...: Yes Shift Hours: 8:00 AM - 4:00 PM Weekend Work: None On Call: No How often will this team member be working remotely? Hybrid Equal Opportunity Employer...Remote workWeekend workPart timeShift work
- ...the following:Completed application via the UM Careers websiteLetter of IntentUpdated... ...WorkPositions that are eligible for hybrid or mobile/remote work mode are at the discretion of the... ...for this position is Night shift, with weekend and holiday rotation.Underfill...Remote workWeekend workWork experience placementNight shift
$81.1k - $116.48k
Appeals and Grievances Clinical Specialist - RN, LPN or Dental Hygienist - 100% Remote Join to apply for the Appeals and Grievances Clinical Specialist - RN, LPN or Dental Hygienist... ...44 and 49 PHL), InterQual, Milliman, or Medicare guidelines. Proficiency with Microsoft...Remote jobFull timeMonday to FridayShift work$50k
...understanding of deductibles, copays, coinsurance, prior authorization, appeals, and payment responsibility. ~ Excellent written... ...Flexibility to work 40 hours between 7am - 9pm EST Option to work the weekend work if preferred, for eg: Sunday - Thursday, 9am-6pm, OR...Remote workWeekend workImmediate start- ...leadership for clinical support staff, including nurses, medical assistants and medical office... ...companies, other medical practices, remote patient monitoring program, laboratory... ...in the techniques/practices of tasks. # Leads group discussions, problem solving and project...Remote workWeekend workFull timeWork at officeAfternoon shift
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