Remote CMS Grievances & Appeals Nurse - 6-Month Contract
PRIDE Health
Pride Health is seeking a Grievances and Appeals Nurse for a remote contract position. This role is vital in investigating and resolving grievances and appeals efficiently for a well-known client. Responsibilities include acting as a subject matter expert, ensuring compliance with CMS regulations, and maintaining extensive knowledge regarding healthcare operations. Candidates should have extensive experience in member services, thorough understanding of CMS policies, and a nursing license valid in Arizona. Pride Health offers a range of comprehensive benefits and is an equal opportunity employer. #J-18808-Ljbffr
- ...Grievances And Appeals Nurse Pride Health is hiring a Grievances and Appeals Nurse for a well-known client! (Remote Contract) Schedule: 5x8s Day shift Contract: 6 months Pay Rate: 40-45/hr Primary Responsibilities... ...in accordance with CMS requirements and...Contract workRemote workCmsWork experience placementLocal areaDay shift
$20 - $30 per hour
...Consulting, Inc in California is seeking a Member Appeals & Grievance Case Manager for a 6+ month contract with long-term potential. This remote position requires expertise in managing... ..., with a strong understanding of CMS regulations. The position offers a pay range...Contract workRemote jobCmsHourly pay- ...Title: Registered Nurse - Claims & Appeals Review Location: Remote (Anywhere in Florida) Duration: 06 Months/Can be Extended Working... ...with NCQA, CMS, and state regulations... ...experience in appeals, grievance, or quality... ...level Employment type: Contract Job function: Health...Contract workRemote workCmsDay shift
$20 - $30 per hour
...Case Manager Appeals & Grievances (California) Immediate need for a talented... ...California). This is a 06+ months contract opportunity with long-term... ...is located in California (Remote). Please review the job... ...~ Strong understanding of CMS, DMHC, and NCQA regulatory...Contract workRemote workCmsLocal areaImmediate start- ...Detroit, Michigan Analyst Contract Job Title: Grievance & Appeals Coordinator Location: Remote Job Description: Top 3 Required... ...computer skills! • Insurance, Medicare/CMS knowledge • Customer Service Experience...Contract workRemote workCmsFlexible hours
$21.16 - $38.37 per hour
Join to apply for the Medicare Appeals & Grievances Specialist (PST Hours) role... .... This position is remote and will be working Pacific... ...knowledge Strong understanding of CMS regulations, Medicare MMP regulations... ...by the department. Applies contract language, benefits and...Contract workRemote workCmsHourly payFull timeWork experience placementWork at office- ...Temporary Grievance & Appeals Nurse (LVN) The position is 100% remote, and the candidates must reside in Southern California. The Temporary Grievance & Appeals Nurse... ...and federal regulatory requirements, including CMS, DHCS, DMHC, and NCQA standards. This role partners...Remote workCmsTemporary workWork at officeImmediate start
$50 per hour
...Medical Review RN IV – Commercial Appeals & Grievance Nurse Location: Remote – Candidate Must Reside in California Duration: 6+ Months Contract-to-Hire Schedule: Monday-Friday | 9:... ...Quality Maintain compliance with NCQA, CMS, DMHC, DHCS, and organizational...Contract workRemote workCmsWork at officeLocal areaMonday to Friday$20 - $23.5 per hour
...Job Description Job Description Grievance and Appeals Coordinator Must write and speak... ...English and Spanish-will be tested Contract position-6 months $20.00-$23.50 Telecommute(must... ...guidelines surrounding Grievances per CMS, DHCS, and DMHC. 2. Understand...Contract workRemote workCmsTemporary workWork at officeImmediate start$88.85k
...Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Location: Los Angeles, CA, US, 9001... ...Centers of Medicare and Medicaid Services (CMS) and regulatory guidelines. Benefit... ..., on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours...Remote workCmsFull timeShift workWeekend work- ...We are seeking a highly skilled Appeals Processor III (APP III) to join our dedicated team in a remote capacity. The Appeals Processor III (APP III) is responsible... ...with federal/state regulations, CMS guidelines, and contract requirements. Qualification and Requirements...Contract workRemote workCms
$30 - $35 per hour
...seeking a Mid-Senior Level professional for a contract role to manage grievances and appeals. Candidates should have 6+ years in customer service with strong organizational... ...$30.00/hr - $35.00/hr based on qualifications. Remote work is available for candidates within 100...Contract workRemote jobFor contractors- A healthcare recruitment firm is seeking a Lead Healthcare Recruiter (Utilization Management RN) for a remote 6-month contract. The ideal candidate will have an active RN license and experience with health plan operations. Responsibilities include evaluating healthcare...Contract workRemote job
$102.18k
Lead Customer Solution Center Appeals and Grievances RN Job Category: Clinical... ...satisfaction goals and regulatory (CMS, DMHC, DHCS, NCQA), Health... ...Associate's Degree in Nursing for Registered Nurses Education... ..., holidays, a hybrid remote schedule, and occasional flexibility...Remote workCmsFull timeShift workWeekend work$60.78k
...Appeals And Grievances Specialist II Job Category: Customer Service Department... ...and Medicaid Services (CMS), California Department of Health... ...issues. Prepare and analyze monthly appeal and grievance reports... ..., holidays, a hybrid remote schedule, occasional flexibility...Remote workCmsFull timeLocal areaShift workWeekend work$37 per hour
...SC 29203 Work Environment: Remote (after 4 weeks of Onsite training... ...- Fri, 8:00 AM - 4:30 PM Contract length: 3 months assignment with possible... ...conversion Note: On call every 4-6 weeks once fully trained,... ...Education: Associate Degree in Nursing, OR Graduate of an...Contract workRemote workCmsWork experience placementLocal areaWeekend work- ...Grievance And Appeals Analyst I The Grievance and Appeals Analyst I is responsible... ...& Medicaid Services (CMS) and National Committee for... ...determinations. Applies contract language, benefit structures... ...accomplished at the end of the day/month. Attendance/punctuality....Contract workCmsFull timeWork at office
- ...now hiring a Registered Nurse for Level 2 Nursery/... ...with no commitment or contract required!! Education... ...of a comprehensive 6-month residency program to support... ...shared governance • CMS 5-Star and Magnet... ...that are available as remote work, Sentara Health...Contract workRemote workCmsTemporary workLocal areaImmediate startRelocation packageShift workNight shift
- Duals Supervisor, Appeals and Grievances United States, Massachusetts... ...of a team of 4-6 appeals and grievance... ...and Medicaid Services (CMS), as well as the National... ...regulatory agencies and contracted clients. Collaborate... ...Conditions: This is a remote role with occasional...Remote workCmsWork at office
$34.42 - $67.6 per hour
...to apply for the Appeals and Letters Coordinator Remote role at Optum... ...position includes 4-6 weeks of paid... ...accordance with CMS and Optum guidelines... ...- Registered Nurse, Physical Therapist... ...Coordinator- Part Time Contracts Specialist/... ....00-$52,416.00 1 month ago Nashville,...Contract workRemote workCmsHourly payMinimum wageFull timePart timeWork experience placementWork at officeLocal areaShift workWeekend work- A staffing solutions company is seeking a Grievance & Appeals Coordinator for a fully remote position in Detroit, MI. This role involves processing... ...and communication skills. This is a W2 contract engagement lasting 12+ months, with a focus on detail and confidentiality....Contract workRemote job
- ...Nurse RN 3 Duration: 6+ months | Possible extension (Contract to Hire/ Temp to Perm) Shift: 8am to 5pm PST Monday - Friday. Location: Remote CA PR: XXXX-48.00/hr Day-to-day responsibilities:... ...approvals for members using CMS evidenced based guidelines, policies...Contract workRemote workCmsPermanent employmentTemporary workMonday to FridayShift work
- ...and coordinate CPPI. Review/respond to grievances and appeals, monthly medication inventory audit, and... ...investigation and resolution in accordance with CMS, CDPH, and DMHC regulations and... ...Regulatory preparation/requirements. 6. Perform periodic random mini- surveys...CmsFull time
$227.95k - $341.93k
...The VP, Provider and Member Appeals and Grievances is an enterprise leader accountable... ...to ensure compliance with CMS Parts C & D, state statutes,... ...denials, claims edits, and contract disputes Drive teams to... ...‑range planning beyond a 12‑month horizon; data‑driven with ability...Contract workCms- ...IMCS Group is seeking an experienced nurse for a 10-month contract role primarily focused on reviewing clinical data and managing member appeal requests in accordance with company policies. The position allows for remote work, preferably from Iowa, with possible on-site...Contract workRemote work
- ...oversee compliance, and mentor junior staff. Candidates should have over 5 years of experience in multi-state payroll, a solid understanding of tax regulations, and proficiency in ADP systems. This is a remote position for a fixed term of 6 months. #J-18808-Ljbffr NamelyContract workRemote jobFixed term contract
- Cornerstone OnDemand is seeking a Senior Payroll Analyst for a 6-month fixed-term remote role. The Analyst will ensure the accurate and timely processing of payroll, maintain payroll systems, and guarantee compliance with payroll laws. Ideal candidates should possess over...Contract workRemote jobFixed term contract
- ...have over 5 years of payroll processing experience, knowledge of ADP systems, and strong analytical skills. The position is remote for a fixed term of 6 months, offering an opportunity to contribute to payroll process improvements. #J-18808-Ljbffr Cornerstone OnDemandContract workRemote jobFixed term contract
- ...seeking a Clinical/Medical Coder for a contractual role lasting 6 months. The coder will handle medical record reviews and apply coding conventions... ...10-CM, CPT, and HCPCS to ensure compliance with payer rules and CMS requirements. The ideal candidate should possess proficiency in...Contract workCms
$175 per hour
...Directors for a high-impact, remote engagement. This... ...Manage prior authorizations, appeals, and grievances while staying compliant with CMS, NCQA, and URAC... ...paced environment. Perks!: Contract-to-Hire Potential: This is a stable 6 to 12-month contract position with a...Contract workRemote workCmsPermanent employmentFull timeMonday to FridayShift work
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