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- ...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....Remote workFull time
$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 jobHourly payMinimum wageFull timeWork experience placementLocal areaWork from homeMonday to Friday- ...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 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- ...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
$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- ...RN Appeals Writer - Remote Detailed review, analysis and extraction of clinical information from patient medical records and drafting of effective narratives for Medicare and Medicaid appeals documentation and briefs in support of denied cases under appeal at all levels...Remote jobWork experience placement
- ...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
$102.18k
...Lead Appeals And Grievances RN Salary Range: $102,183.00 (Min.) - $163,492.0... ...Appeals and Grievance (A&G) clinical unit. This position is responsible... ...least 2 years in Medicare/ Medicaid in a managed care/ health... ..., holidays, a hybrid remote schedule, and occasional flexibility...Remote workShift workWeekend 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 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
- 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
...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$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- ...Clinical Coordinator, RN - EM Follow Up - Roanoke (Open) This position is working full time, daytime hours and occasional weekends. This is... ...CRMH) in Roanoke, VA in the Emergency Department with 1 day remote. The Clinical Coordinator: Utilizes advanced nursing...Remote workFull time
$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- ...MES Solutions is seeking a Registered Nurse (RN) to join our Clinical Quality Assurance team as a Clinical Quality Assurance Coordinator. This 100% remote role focuses on reviewing peer review reports, ensuring evidence-based rationales, and maintaining compliance with...Remote 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
- ...work a weekend rotation, one every 6 weeks Will work a holiday rotation, one two per year Position Overview The Clinical Intake Coordinator is responsible for gathering necessary information from referral sources, promoting Agency services, and functioning as a...Remote jobDaily paidFull timeTemporary workWork at officeLocal areaImmediate startMonday to FridayShift workWeekend workAfternoon shift
$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- ...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
- ...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
- ...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- ...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
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