Remote RN Appeals and Quality of Care Investigator
Elevance Health
- Remote job
A healthcare company is seeking a Nurse Appeals specialist to investigate and process medical necessity appeals from members and providers. The role involves reviewing grievances, preparing summaries for Quality of Care cases, and ensuring timely resolution of grievances. Applicants need a high school diploma or equivalent with at least 2 years of experience in a managed care setting, along with a current RN license. This position offers a hybrid work model and a range of competitive benefits. #J-18808-Ljbffr Elevance Health
- ...onboarding and skill development. The Nurse Appeals is responsible for investigating and processing medical necessity... ...reviews of member grievances and Quality of Care cases. Review medical records for... .... Current active unrestricted RN license to practice as a health professional...SuggestedFull timeTemporary workLocal area1 day per week
$72.8k - $130k
...collaborating with healthcare providers, and managing quality of care concerns. Candidates must have an active Arizona RN license and experience in long-term care nursing... .... The position offers flexibility to work remotely with occasional travel within the state. Salary...Remote job$35.29 - $54.71 per hour
...Aurora, Colorado seeks a Registered Nurse for Virtual Acute Care to monitor patients from the remote center in collaboration with the onsite inpatient team.... ...nursing care in a virtual setting, support safety and quality, participate in staff development, and benefit from...Remote workHourly payAfternoon shift$35.29 - $54.71 per hour
...CO:Aurora Department: Virtual Quality Support FTE: Full Time, 0.9,... ...and does not offer a hybrid or remote option Picture yourself on a... ...of scope practice in a virtual care environment utilizing the... ...at the point of care Virtual RN Provides patient monitoring from...Remote workFull timeTemporary workLocal areaFlexible hoursShift workNight shift$72.8k - $130k
...of inpatient and outpatient care delivered to adults and children... ...peer review and internal investigations of Quality of Care concerns Create... ...potential Quality of Care concerns Remote Work and Travel Location:... ...Active, unrestricted RN license in the state of Arizona...Remote jobMinimum wageFor contractorsWork experience placementWork at officeLocal area$35.29 - $54.71 per hour
Join to apply for the RN Acute Care Virtual Quality Support role at TieTalent 1 day ago Be among the first 25 applicants Join to apply for the RN... ...position is an onsite role and does not offer a hybrid or remote option** Minimum Requirements Graduate of an accredited...Remote workShorter hoursFull timeTemporary workLocal areaRelocation packageFlexible hoursShift workNight shift- ...the direction of the primary care operations team, the Primary Care... ...clinical care team to drive quality outcomes for an attributed panel... ...Details: ~ Full Time RN/LPN Position @ Mercy Family Medicine... ...~ Hours: 8a-5p ~ Hybrid/Remote Position ~90 days of onsite...Remote workFull time
$67k - $85k
...Duly Health and Care is seeking a Quality Improvement Nurse to enhance clinical quality metrics and patient outcomes. This full-time role is remote with occasional travel to Downers Grove, IL. Candidates... ...a Bachelor’s in nursing and an RN license in Illinois, along with...Remote workFull time- MVP Health Care is seeking a Prospective Review Registered Nurse to evaluate medical requests and treatment plans in a remote capacity. You will work closely with Medical Directors and healthcare... ...Ideal candidates will have an active RN license in NY or VT and 3-5 years of...Remote job
- ...Solutions seeks a Utilization Management RN to assess medical necessity and authorize... ...Services and Medical Directors to optimize care. The role requires 4+ years of RN experience... ...analytical and communication skills. Remote work options available within approved states...Remote job
$35.29 - $54.71 per hour
...and does not offer a hybrid or remote option Minimum Requirements... ...as a Registered Nurse (RN). Basic Life Support (BLS) Healthcare... ...practice in direct patient care utilizing the nursing process... ...Contributes to secure safety and quality at the point of care Acute...Remote workFull timeTemporary workLocal areaFlexible hoursShift workNight shift$35.29 - $54.71 per hour
...Department: Highly specialized in the care of all solid organ transplants... ...does not offer a hybrid or remote option. Minimum... ...licensure as a Registered Nurse (RN). Basic Life Support (BLS) Healthcare... ...to secure safety and quality at the point of care Acute...Remote workFull timeTemporary workLocal areaFlexible hoursShift workWeekend work$35.29 - $54.71 per hour
...and does not offer a hybrid or remote option Work nights, earn... ...licensure as a Registered Nurse (RN). ~6 months of nursing (RN)... ...scope practice in direct patient care utilizing the nursing process... ...to secure safety and quality at the point of care Acute...Remote workFull timeTemporary workLocal areaFlexible hoursShift workNight shift$35.29 - $54.71 per hour
...and does not offer a hybrid or remote option Work nights, earn... ...licensure as a Registered Nurse (RN). ~6 months of nursing (RN)... ...scope practice in direct patient care utilizing the nursing process... ...to secure safety and quality at the point of care Acute...Remote workFull timeTemporary workPart timeLocal areaFlexible hoursShift workNight shift$35.29 - $54.71 per hour
...role and does not offer a hybrid or remote option Summary: Provides direct patient care, at a proficient level, using the... ...licensure as a Registered Nurse (RN). ~6 months of nursing (RN)... ...contributions to our success in quality, patient experience, organizational...Remote workTemporary workReliefLocal areaFlexible hoursShift work$35.29 - $54.71 per hour
...and does not offer a hybrid or remote option Minimum Requirements... ...as a Registered Nurse (RN). ~6 months of nursing (RN)... ...scope practice in direct patient care utilizing the nursing process... ...Contributes to secure safety and quality at the point of care Acute...Remote workFull timeTemporary workLocal areaFlexible hoursShift work$35.29 - $54.71 per hour
...Department: Rehabilitation Patient Care Unit Work Schedule: Part... ...does not offer a hybrid or remote option Minimum Requirements... ...licensure as a Registered Nurse (RN). 6 months of nursing (RN)... ...Contributes to secure safety and quality at the point of care Acute...Remote workTemporary workPart timeLocal areaFlexible hoursShift work$35.29 - $54.71 per hour
...Pueblo Department: Acute Care Float Pool Work Schedule: Full... ...does not offer a hybrid or remote option Minimum Requirements... ...licensure as a Registered Nurse (RN) ~6 months of nursing (RN)... ...Contributes to secure safety and quality at the point of care Acute...Remote workFull timeTemporary workLocal areaFlexible hoursNight shiftRotating shift$35.29 - $54.71 per hour
...and does not offer a hybrid or remote option Minimum Requirements... ...as a Registered Nurse (RN). ~6 months of nursing (RN)... ...scope practice in direct patient care utilizing the nursing process... ...Contributes to secure safety and quality at the point of care Acute...Remote workTemporary workPart timeLocal areaFlexible hoursShift workNight shift$50 per hour
...healthcare technology company is seeking a Care Transition Nurse to join its team and... ...for accuracy and logic, and enhancing the quality of the models. Applicants should have a background... ...flexibility with full-time or part-time remote options and projects paid hourly starting...Remote workHourly payFull timePart time$35.29 - $54.71 per hour
...and does not offer a hybrid or remote option Work nights, earn... ...licensure as a Registered Nurse (RN). ~6 months of nursing (RN)... ...scope practice in direct patient care utilizing the nursing process... ...to secure safety and quality at the point of care Acute...Remote workFull timeTemporary workLocal areaFlexible hoursShift workNight shift- ...Registered Nurse (RN) | Intermediate Care Location: Roanoke, VA Agency: Concentric Healthcare... ...populations Familiarity with remote telemetry monitoring environments Prior... ...ratio of 1:5 with a staffing goal of 1:4, supporting quality patient care delivery...Remote workWeekly payFull timeContract workImmediate startShift workNight shiftWeekend work
$35.29 - $54.71 per hour
...Surgical Trauma FTE for Acute Care (MedSurg): Full Time, 72.00... ...and does not offer a hybrid or remote option Work nights, earn... ...licensure as a Registered Nurse (RN). Basic Life Support (BLS)... ...Contributes to secure safety and quality at the point of care Acute...Remote workFull timeTemporary workLocal areaFlexible hoursShift workNight shift$35.29 - $54.71 per hour
...and does not offer a hybrid or remote option Work nights, earn... ...licensure as a Registered Nurse (RN). ~6 months of nursing (RN)... ...scope practice in direct patient care utilizing the nursing process... ...to secure safety and quality at the point of care Acute...Remote workFull timeTemporary workLocal areaFlexible hoursShift workNight shift- ...Solutions is seeking an Utilization Management RN to evaluate medical necessity and... ...prevent unnecessary procedures. The role supports remote work in approved states and requires RN licensure with substantial managed care experience. #J-18808-Ljbffr WPS Health SolutionsRemote job
- ...Registered Nurse (RN) | Intermediate Care Location: Roanoke, VA Agency: Concentric Healthcare... ...environment Familiarity with remote telemetry monitoring and tele-sitting... ...Commission’s national set of consensus-based quality standards and demonstrates a...Remote workWeekly payFull timeContract workTemporary workImmediate startShift workWeekend workDay shift
- ...Registered Nurse (RN) | Intermediate Care Location: Roanoke, VA Agency: Concentric Healthcare... ..., and Ketamine Experience with remote telemetry monitoring environments Why... ...Commission’s national set of consensus-based quality standards and demonstrates a...Remote workWeekly payFull timeContract workTemporary workLocal areaImmediate startNight shift
- ...Registered Nurse (RN) | Intermediate Care Location: Roanoke, VA Agency: Concentric Healthcare... ...beds preferred Familiarity with remote telemetry monitoring and tele-sitting... ...Commission’s national set of consensus-based quality standards and demonstrates a...Remote workWeekly payFull timeContract workTemporary workImmediate startShift workWeekend workDay shift
- ...Registered Nurse (RN) | Intermediate Care Location: Chattanooga, TN Agency: Concentric Healthcare... ...with care team members and remote chart access via Patient Keeper Participate... ..., and Phillips telemetry, supporting efficient and high-quality patient care...Remote workWeekly payFull timeContract workImmediate startShift workNight shiftWeekend work
- ...Registered Nurse (RN) | Intermediate Care Location: Roanoke, VA Agency: Concentric Healthcare... ...and operate within telemetry and remote monitoring environments Float within... ...Commission’s national set of consensus-based quality standards and demonstrates a...Remote workWeekly payFull timeContract workTemporary workImmediate startShift workNight shiftWeekend work
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