Remote UM & Grievance Appeals RN (NY Licensed)
Phaxis
- Remote job
Phaxis is hiring a Remote UM / Grievance & Appeals RN (NY License) for a contract role with a New York health plan. If you have owned appeals from intake to final decision letter, we want to talk to you. You will review medical necessity for outpatient and community-based services, draft determination letters, and prepare cases for Fair Hearings and CMS external reviews. A NY RN license and payer-side experience are required. #J-18808-Ljbffr Phaxis
$53 per hour
...Job Description Job Description REMOTE RN OPPORTUNITY – GRIEVANCE & APPEALS / UTILIZATION REVIEW $53/hour | 100% Remote | Long-Term... ...contract opportunity Requirements Active NY RN license Direct outpatient UM experience. Strong outpatient Utilization...Remote jobLong term contractWork from homeMonday to FridayShift workWeekday work$52 - $56 per hour
...Description You've done UM. You've worked appeals. Now find a role... ...a contract RN for a New York... ...'ll own clinical grievances and appeals from... ...management. 100% remote (U.S.) | Contract... ...New York State RN license (compact alone... ...Medicare Part C and/or NY Medicaid/MLTC...Remote jobContract workAfternoon shift- ...to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This role collaborates with our Medical Director to... ...benefit and medical necessity reviews within an NCQA-compliant UM program. The UM Nurse will review criteria, approve eligible requests...Remote job
- ...service and post-service utilization reviews and appeals for DMEPOS. You will collaborate with our... ...and medical necessity reviews meet NCQA UM standards, using InterQual and CMS guidelines. The role supports a nationwide remote workforce with competitive compensation,...Remote job
$22 per hour
...patients. CareHarmony is seeking an experienced Licensed Practical Nurse - LPN Nurse (LPN) (NLC) (... ...patients. What’s in it for you? Fully remote position - Work from the comfort of your... ...starts at $22/hr ($21/hr + $1/hr NY license bump) with the ability to earn up...Remote jobFull timeWork experience placementWork at officeHome officeMonday to FridayDay shift$83.1k - $120.36k
Position Summary: The Appeals & Grievances (A&G) unit manages... .... This is either a remote or on-site position located... ...Qualifications: ~ RN , LPN OR Dental... ...Greater New York City Area (NY, NJ, CT residents): $8... ..., education, licenses and certifications, and...Remote workContract workTemporary workWork experience placementLocal area- ...initiatives for their patients.CareHarmony is seeking an experienced Licensed Practical Nurse – LPN Nurse (LPN) (NLC) (LVN) with at least 3... ...chronic care management patients.What's in it for you?Fully remote position - Work from the comfort of your own home in cozy...Remote workFull timeWork experience placementMonday to FridayDay shift
- ...Hospital Utilization Management (UM) Nurse, you are the primary... ...administrative compliance. Unlike remote roles, this position relies... ...UM Nurse is a Registered Nurse (RN) responsible for performing admission... ...Required Minimum License(s) and Certification(s): All...Remote workFull timeImmediate startShift work
$77.91k - $116.86k
...inpatient review nurse to join the remote utilization management team. As... ...criteria as established per UM policy and procedure. 12.... ...Successful completion of an accredited Licensed Vocational Nursing Program •... ...valid, and unrestricted LVN or RN license in California (Non-...Remote workFull timeImmediate startMonday to Friday$68.4k
...SUMMARY This is a full-time REMOTE position requiring weekend availability... ...Preferred ~3 years RN experience ~ RN Case Management... ...Care Management ~ Experience in UM/CM/QA/Managed Care ~... ...nursing, inpatient Rehab LICENSES AND CERTIFICATIONS Required...Remote workFull timeFor contractorsWork at officeLocal areaFlexible hoursWeekend workWeekday work- ...Medi-Cal Appeals And Grievances Rn SeniorThe Medi-Cal Member Appeals and Grievances team is responsible for clinically reviewing member appeals and grievances that are the result of either a preservice, post-service or claim denial. The Medi-Cal Appeals and Grievances...Full timePart timeWork at officeLocal areaWork from homeHome office2 days per week
- ...of 8am-5pm Pactific Time. Essential Job Duties • Serves as team lead for submission, intervention and resolution of appeals, grievances, and/or complaints from Molina members, providers and related outside agencies. • Trains new employees and provides guidance...Remote workContract workWork at officeShift work
- The Appeals and Grievances Medical Director at UnitedHealthcare oversees ongoing clinical review and... .... This role offers full remote work across the United States, with limited... ...markets; requires MD or DO with an active license, board #J-18808-Ljbffr UnitedHealth GroupRemote jobWork at office
- DrHouse, Inc. is seeking board-certified Internal Medicine physicians to join our telemedicine team. This fully remote, NY-licensed role offers a flexible schedule and the opportunity to care for patients statewide via secure virtual consultations. You will manage a broad...Remote jobFlexible hours
$125 per hour
...choice. \n \n \n # Registered Nurses (RN), the heart of the team. You drive to the... ...for the drip, and chart it. Active RN license in NY or NJ (both is a plus), current BLS (ACLS... ...license with prescriptive authority. Mostly remote with flexible hours. \n # Physicians (...Remote workDaily paidFull timePart timeWork at officeFlexible hours$70.38k - $74.96k
...agency that posted this position by using the contact information provided on the \"Contact\" tab for the position. Title Licensed Practical Nurse (NY HELPS), Kingsboro Psychiatric Center, Mary Brooks, P28206 Occupational Category Health Care, Human/Social Services...Permanent employmentFull timeInternshipWork at office$100k - $130k
...Utilization Management (UM) team plays a vital... ...guidelines. As the Lead RN, Utilization... ...Collaborate with Appeals and Grievances, Care Management, Claims... ...active, unrestricted RN license Bachelor of Science... ...Additionally, we embrace a remote-first culture that...Remote workFull timeWork experience placementWork at officeFlexible hours- Summary We are currently hiring for an RN Appeals Analyst to join BlueCross BlueShield of South... ...30am-5:00pm EST and will be fully remote in South Carolina or Georgia. What... ...Tools: Microsoft Office. Required License and Certificate: An active, unrestricted...Remote workFull timeFor contractorsWork experience placementCurrently hiringWork at officeLocal areaMonday to Friday
$72k - $81k
...communication with all members of the health care team. This is a remote/work-from-home position. License Requirements: Registered Nurse (current active and... ...territories.) MedWatch reimburses for renewals of RN licenses outside of primary state of residence....Remote workTemporary workWork at officeWork from homeHome office$262k - $278.5k
...some evenings and weekends) * Location: Remote, must reside in the United States What you... ...of 4-8 NP or PA colleagues Education, licenses and experience required for this role: *... ...Medicine * Active state license in either CA, NY or DC * In addition, minimum of 15 state...Remote workFull timeTemporary workWork at officeAfternoon shift$20 - $36 per hour
$5,000 Sign On Bonus for External Candidates Optum NY, is seeking a Licensed Practical Nurse - Pediatric Endocrinology to join our team in Lake Success, NY. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member...Hourly payMinimum wageFull timeWork experience placementLocal areaWork from homeRelocation packageMonday to Friday$42 per hour
...opening for the following position: Pediatric 1:1 Nurse in Brewster, NY. Our passionate and talented team members have made The... ...~ Referral Bonus incentives starting at $500 per referral ~ Remote onboarding available Apply now for immediate consideration...Remote workDaily paidFull timePart timeCurrently hiringImmediate startFlexible hoursShift workNight shiftWeekend work$45 - $50 per hour
...Licensed Practical NurseTryfacta is seeking a Licensed Practical Nurse for our client in Rochester, NY 14617. This is a 13-week contract assignment. If you... ...under the direction of an RN Care Manager to implement... ...care. This is primarily a remote and telephonic care coordination...Remote workContract workLocal area$27 - $30 per hour
...Description Job Description Immediate need for a talented Appeals & Grievances Case Manager (Oregon) . This is a 12+ Months Contract opportunity with long-term potential and is located in US (Remote) . Please review the job description below and contact me ASAP...Remote workContract workLocal areaImmediate start$27 - $30 per hour
...Immediate need for a talented Appeals & Grievances Case Manager (Oregon) . This is a 12 Months Contract opportunity with long-term potential and is located in US(Remote) . Please review the job description below and contact me ASAP if you are interested. Job ID:...Remote workContract workLocal areaImmediate start- ...We are searching for a new RN to join our team. Our Nurses... ...enjoy the flexibility to work remotely and do not have face-to-face... ...unrestricted RN state license Graduate from an accredited... ...preferably in the capacity of Appeals/Grievances, Case Management,...Remote workHome officeMonday to FridayWeekend work
$45 per hour
...Noor Staffing Group Hiring Noor Staffing Group is hiring Licensed Practical Nurses (LPNs) for immediate openings at a Long-Term Care (LTC) facility in Jamaica, NY. Day, evening, and night shifts are available. Candidates must be available to work every other Saturday...Full timeImmediate startShift workNight shiftWeekend workDay shiftAfternoon shift- ...Registered Nurse (RN) – Remote Triage / Compact License Required Make a difference from home while supporting patients and providers nationwide. We are seeking experienced Registered Nurses (RNs) to join our growing 24-hour medical call center as a Remote Triage...Remote workFull timeWeekend workAfternoon shift
- ...Location: 100 Kings Hwy S Rochester, NY 14617 Schedule: Day Shift 5x8-... ...Campus Role Type: Mobile / Remote / Hospital-based Care... ...Mobile Case Management preferred License/Cert: BLS required Locals: Accepted... ...0-day readmissions. Work under RN Care Manager to implement the Plan...Remote workWeekly payFull timeContract workWork at officeLocal areaFlexible hoursDay shift
- ...Fully remote (never coming onsite) The Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) will provide processing and communication of Commercial Prior Authorizations (PA) and Appeals reviewed by the Commercial PA and Appeals team for Pharmacy benefits....Remote workPermanent employmentWork at officeShift work
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