Appeals RN - MassHealth (Remote in MA)
Crains Cleveland
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
- ...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 work
- ...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 workFlexible hours
- ...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 work
$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 jobHourly pay$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 workHourly payFull timeContract workWork at officeShift workNight shiftWeekend work$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 workHourly payFull timeContract workWork at officeShift workNight shiftWeekend work- ...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 work
$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 jobPermanent employmentTemporary workShift work$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 workHourly payMinimum wageFull timeTemporary workWork experience placementWork at officeLocal area- ...for the coordination, facilitation, and appeal of the clinical components of charge audits... ...in Nursing required Registered Nurse [RN - MA State License] - required 3+ years of experience... ...for nursing staff. Working schedule Remote, M-F eastern standard business hours. Requires...Remote work
- ...professionals, such as licensed vocational nurses (LVNs). We're also open to remote providers who don't live in Austin, TX. ABOUT US Modern... ...patients ABOUT YOU Experience in pediatrics as a triage nurse or MA High emotional intelligence and an empathy-first approach with...Remote workHourly payLive inFlexible hoursWeekend workAfternoon shift
- ...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 workHourly payLive inWeekend workAfternoon shiftWeekday work
$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...Remote workHourly pay- ...Cambia Health Solutions seeks an Appeals Clinician I to leverage clinical expertise in resolving appeals while enhancing patient advocacy... ...will hold a Bachelor's Degree in Nursing and possess a current RN license, alongside excellent skills in claim reviews and healthcare...Remote workWork from home
- ...Cambia Health Solutions is seeking an Appeals Clinician I to work from home within Oregon,... ...Bachelor's Degree in Nursing and an active RN license in the relevant state, along with... .... Cambia offers competitive compensation, remote work options, and a comprehensive benefits...Remote workWork from home
$90k - $99k
...DRG Nurse Reviewer Appeals and Hearings- Remote Date: Jan 9, 2026 Location: Any city, FL, US, 99999 Work Mode: Virtual (Exception only) It... ...guidelines; successfully completes required CEUs to maintain RN license and/or coding certification. Responsible for...Remote workFull timeWork from homeFlexible hours- ...Cambia Health Solutions seeks an Appeals Clinician I to handle clinical appeal processes while working from home within specific states... ...Candidates must have a Bachelor's Degree in Nursing and an active RN license in Oregon, Washington, Idaho, or Utah. This position...Remote workWork from home
$50 per hour
...A leading healthcare staffing firm is seeking an experienced RN Clinical Reviewer to work remotely. You'll conduct detailed medical-legal reviews and appeals while maintaining high accuracy and integrity. Key qualifications include a New York State RN license and at least...Remote work$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 payFull timeLocal areaImmediate startFlexible hoursShift workNight shiftWeekend work- ...Cambia Health Solutions is seeking an Appeals Clinician I to utilize clinical expertise in resolving member and provider appeals. This role offers work-from-home options within specific states and requires a Bachelor's Degree in Nursing with relevant experience. Key responsibilities...Remote workWork from home
- ...Cambia Health Solutions is seeking an Appeals Clinician I to use clinical expertise in resolving member and provider appeals. Located in... ...candidates will have a Bachelor's Degree in Nursing and a current RN license in relevant states. This position offers flexible work-...Remote workWork from homeFlexible hours
$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 payFull timeLocal areaImmediate startFlexible hoursShift workNight shiftWeekend work- ...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 workWork from home
$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 workWork from homeFlexible hours$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 workFlexible hours$2,997 - $3,183 per week
...Registered Nurse (RN) | Operating Room Location: Fall River, MA Agency: AMN Healthcare Pay: $2,997 to $3,183 per week Shift Information... ...culturally rich New England community makes this an appealing opportunity for travelers looking to grow professionally...Extra incomeFull timeContract workTemporary workSeasonal workLocal areaShift workWeekend workDay shiftEarly shift$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...Remote workHourly pay- 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
- ...Cambia Health Solutions is looking for an Appeals Clinician I to join our team in Minot, ND. In this role... ...possess a Bachelor's Degree in Nursing, a valid RN license, and relevant clinical experience. The role offers remote work options and a competitive salary scheme...Remote work
- ...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 contact...Remote workFull timePart time
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