Remote Clinical Appeals RN - MassHealth Specialist
Sacbar
Boston, MA
- Remote job
Optum, a part of UnitedHealth Group, seeks a Clinical Appeals RN to attend MassHealth appeal hearings, defend prior authorization decisions, and conduct clinical coverage reviews for the MA program. This role supports the MA MLTSS program and requires in-state nursing credentials. The position offers telecommuting from Massachusetts, a collaborative team, and opportunities for professional growth. Requires Associate's degree in Nursing, MA RN license, and 3+ years of managed care or clinical #J-18808-Ljbffr Sacbar
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Remote Clinical Appeals RN - MassHealth Specialist in Boston, MA vacancy
- UnitedHealth Group in Massachusetts is seeking a Clinical Appeals RN to attend appeal hearings and defend MassHealth prior authorization decisions. The role supports pre-service/prior authorization reviews and requires MA licensure and clinical experience. The position...Remote job
- Optum is a global organization delivering care supported by technology to help millions live healthier lives. The Clinical Appeals RN defends MassHealth prior authorization decisions and conducts pre-service reviews, working with managers and peers. Based in Massachusetts...Remote job
- UnitedHealth Group is seeking a Clinical Appeals RN to attend MassHealth appeal hearings, defend prior authorization decisions, and perform pre-service... ...license, and 3+ years in Managed Care or clinical settings. Remote work within Massachusetts is available with some travel...Remote job
- 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
Healthfirst
New York, NY2 days ago - UnitedHealth Group is seeking a Clinical Appeals RN in Massachusetts to join our team and support MassHealth appeal hearings and prior authorization decisions. This role offers telecommuting flexibility for MA residents and requires strong clinical knowledge and collaboration...Remote jobHome office
- Providence Health & Services is seeking an Appeals RN in Case Management for a remote, per diem role working 8-hour day shifts. The Care Management Recovery Advocate will manage clinically-based appeals between Providence California Region and outside payers, focusing on...Remote jobDaily paidDay shift
- ...classified as hybrid, onsite or remote. While the majority of our... ...job Responsible for utilizing clinical acumen and managed care expertise... ...for member and provider appeals, grievances, reconsiderations... ...state as a Registered Nurse (RN) Required Certifications N/A...Remote jobContract workWork experience placement1 day per week
$28.94 - $51.83 per hour
...Clinical Appeals RN Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier... ...RN is responsible for attending appeal hearings, defending MassHealth prior authorization decisions, and performing pre-service/prior...Remote jobHourly payMinimum wageFull timeTemporary workWork experience placementWork at officeLocal area- UnitedHealthcare is seeking a Clinical Appeals RN to provide expertise in clinical appeals and grievances, analyzing, reviewing, and evaluating... ...members and benefits. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough...Remote job
$70k - $80k
...Piper Companies is seeking a Remote Clinical Appeals Analyst to provide clinical expertise in reviewing and resolving complex member and provider... ...must hold an active North Carolina licensure as an RN, LPN, PT, or OT and have significant clinical experience. The...Remote workFull timeContract workMonday to FridayPiper Companies
Cary, NC5 days ago- UnitedHealth Group is seeking a Clinical Appeals RN to analyze appeals and grievances, acting as a clinical interface liaison with facilities, providers, and carriers. Remote work is offered across the U.S. with a M-F schedule and alternating Saturdays. Responsibilities...Remote job
- Healthfirst is seeking an A&G Clinical Specialist to lead the development and resolution of clinical cases for member and provider appeals, ensuring compliance with applicable laws and internal policies. The role can be remote or on-site at the NYC or Lake Mary locations...Remote work
- Inova Health System is seeking a Registered Nurse (RN) for Clinical Denials and Appeals. This full-time remote role supports denials and appeals across facilities, with start times between 7:30 AM-9:00 AM ET. The role requires a bachelor’s or associate degree with RN license...Remote jobFull time
- Inova Health System is seeking a dedicated Registered Nurse (RN) Clinical Denials and Appeals to join the team as a Full-Time Remote role. The position supports review of denied claims, development and submission of timely appeals, and collaboration across UR, Coding, Billing...Remote jobFull time
- UnitedHealthcare is seeking a Clinical Appeals RN to provide expertise in appeals and grievances, serving as a Clinical Interface Liaison with facilities, providers, and carriers. The role allows remote work from anywhere in the U.S., with a schedule of M-F 8:00-4:30 and...Remote job
- ...skilled Registered Nurse for an outpatient Pacemaker/Device Clinic. You will perform in-clinic and remote device checks and support device management for... ...documentation and timely follow-ups. A BSN/ADN and IL RN license are required, with 1-2 years of clinical experience...Remote work
- ...Cottage Hospital is seeking a PRN Clinical Review Specialist to provide remote clinical review support. You will evaluate... .... The role requires an active RN license (compact preferred), 3-5... ...and 2+ years in Utilization Review/Appeals. Strong documentation and Epic EMR...Remote jobRelief
- Medica, a nonprofit health plan, is seeking a remote Appeals & Grievances Clinical Specialist III to review and resolve appeals and grievances with clinical... ...and clinical staff. This position requires an active RN license and 5+ years of clinical experience, preferably...Remote job
- Payfuture Technologies is seeking a Clinical Documentation Integrity (CDI) Specialist to ensure accurate clinical documentation in a remote setting, with optional on-site presence. This role requires a Massachusetts RN license and involves reviewing medical records for...Remote job
$71.59k - $116.48k
...prominent healthcare organization is seeking an A&G Clinical Specialist to manage health member complaints and appeals. This fully remote position requires expertise in clinical case... .... The ideal candidate should be an RN, LPN or Dental Hygienist with experience in appeals...Remote job- UnitedHealth Group is seeking an experienced Clinical Appeals RN to analyze and resolve appeals and grievances. This remote role supports facilities, providers, and members by applying clinical criteria and coordinating with Medical Directors. Responsibilities include...Remote job
$28.94 - $51.63 per hour
...Join us to start Caring. Connecting. Growing together. The Clinical Appeals RN is responsible for providing expertise in clinical appeals and... ...and clarification). You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges...Remote jobHourly payMinimum wageFull timeWork experience placementWork at officeLocal areaWeekday work- CVS Health Corporation is seeking a Nurse Clinical Educator to provide infusion education and clinical support for pulmonary arterial hypertension patients. The role combines home visits with remote work, offering flexible per diem scheduling and 29 hours weekly in a part...Remote workDaily paidPart timeWork from homeFlexible hours
- Registered Nurse (RN) Clinical Denials and Appeals United States Job Description Inova 8095 - Fairfax East is looking for a dedicated Registered Nurse... ...Appeals to join the team. This role will be Full-Time Remote, Monday-Friday (8-Hours per Day); Start Time to be between...Remote workFull timeMonday to FridayFlexible hours
$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 - 100% Remote role at Healthfirst . Position Summary: The Appeals & Grievances (A&G) unit...Remote jobFull timeMonday to FridayShift work$81.1k - $116.48k
Position Summary: The Appeals & Grievances (A&G) unit... ...authorization of or delivery of clinical and non-clinical... .... The A&G Clinical Specialist is the subject matter expert... ...This position is 100% Remote. We are hiring for the... ...Qualifications: RN, LPN OR Dental Hygienist...Remote jobContract workTemporary workWork experience placementLocal areaMonday to FridayShift work- ...Clinical Coordinator Under the general direction of... ...coordination of care for those MassHealth members who have... ...to inquiries related to appeals following clinical... ...experience required OR RN licensed to practice in... ...team of clinicians Remote/desk work with- some statewide...Remote workWork experience placementWork at office
ForHealth Consulting - Community Service - W401950
Westborough, MA5 days ago $29.7 - $31.8 per hour
...0 based on experience The Acute Coding Appeals Specialist integrates medical coding principles and... ...the assigned DRG and to address the clinical documentation utilized in the decision-... ...patient and client experiences. This is a remote position; however, candidates must be...Remote workTemporary workWork at officeEnsemble Health Partners
United States3 hours ago$50k
...to bring accuracy, accountability, and clinical excellence to healthcare. As such, we are... ...and Readmission reviews. The Appeals Specialist I is responsible for performing triage,... ...atmosphere of frequent interruptions Remote Work Requirements ~ High speed internet...Remote workContract workWork experience placementMed Review Inc
United States5 days ago- ...ensuring accurate documentation and care coordination. Staggered Remote Position This position requires 3 months of in department... ...include the following, other duties may be assigned: Clinical Triage Specialist must be able to demonstrate knowledge of growth and...Remote jobPart timeWork from home
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Clinical Appeals RN - MassHealth Specialist. Be the first to apply!
Related searches
- wound rn Boston, MA
- entry level registered nurse Boston, MA
- psych rn Boston, MA
- non clinical rn Boston, MA
- clinic registered nurse rn Boston, MA
- outpatient surgery centers rn Boston, MA
- part time rn Boston, MA
- rn relocation bonus Boston, MA
- registered nurse healthcare Boston, MA
- rn relocation assistance Boston, MA