RN Manager Grievances & Appeals - Hybrid
Midland-Marvel Recruiters, LLC
Hospital system looking to bring on RN Manager Grievances & Appeals! Sign On Bonus and Relocation!
- Oversees and provides direction for Intake, Appeals (Clinical and Claims), Retrospective Review, Emergency Room Review, and Customer Service/Complaints/Grievances for all lines of business.
- Responsible for day to day oversight and management of Intake, Clinical Appeals, Claims Appeals, Complaints, Grievances and Intake functions.
Qualifications:
- Bachelor’s degree in Nursing Required
- Experience working in a Managed Care Organization with strong experience in Medicaid
- Specific Experience working with Grievances and Appeals (minimum of 3 years)
- 3-4 years in UM and 5-7 years of clinical experience in a hospital or medical setting
- 2 years of nursing leadership as a supervisor or assistant manager
- KSAs Proficiency
- CCM - Certified Case Manager Active Certified Case Manager (CCM) or CCM certification within 1 Year Required
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the RN Manager Grievances & Appeals - Hybrid in Washington DC vacancy
- ...success. JOB SUMMARY: The DRG Appeals Specialist performs reviews of... ...HAVES: Current and valid RN license DRG validation... ...the intersection of utilization management, revenue cycle, and compliance... ...dues This is a hybrid position - requires 50% travel...SuggestedFull timeTemporary workWork at officeImmediate startFlexible hours
$37.3 - $62.16 per hour
...Case Manager Hybrid I/II at Children's National Hospital Kids Are Our Everything. Pay Range: $37.30 - $62.16 This is a PRN (as needed) position. What You'll Do: As a Case Manager Hybrid I/II at Children's National Hospital, you will serve at the heart of patient...SuggestedFor contractorsWork experience placementRelief$50 - $52 per hour
...a fully developed Skin Health and Wound management program in collaboration with nursing center... .... Qualifications: *Must possess a RN license (MPT/DPT with leadership review/approval... ..., completion of a fast-track hybrid program for regulatory wound care requirements...SuggestedTemporary workImmediate startLarkin Chase Center
Bowie, MD6 hours ago- ...Make your next move count as an RN Care Manager , combining meaningful patient advocacy, visible leadership support, professional growth... ...transitions, and collaboration across the continuum, making this an appealing destination for professionals exploring nursing jobs,...SuggestedWeekend work
Clinical Management Consultants
Washington DC3 days ago - ...Registered Nurse Case Manager Inova Fairfax Medical Campus is looking... ...flexible work schedules, and remote and hybrid career opportunities. Registered Nurse (RN) Case Manager 1 Job... ..., readmission rates, denials and appeals. Collects, analyzes and addresses...SuggestedFull timePart timeReliefRemote workRelocation packageMonday to FridayFlexible hoursWeekend work
$36.32 - $46 per hour
...Summary V- Tech Solutions is seeking a Registered Nurse (RN) Care Manager to provide comprehensive care coordination services for... ...competence and family-centered care Work Environment Hybrid position with office-based and community-based work. Pay Range...Hourly payWork at officeV-Tech Solutions
Washington DC1 day ago$50 - $52 per hour
...a fully developed Skin Health and Wound management program in collaboration with nursing center... .... Qualifications *Must possess a RN license (MPT/DPT with leadership review/approval... ..., completion of a fast-track hybrid program for regulatory wound care requirements...Temporary workImmediate startGenesis Healthcare Services
Bowie, MD4 days ago- ...Job Requirements Under general supervision of the Manager, Case Management, coordinates the clinical and financial plan for patient... ...written documents accurately and timely (e.g. Denial and Appeal report). Provide information to and confer with the managed...Work experience placement
University of Maryland Medical System
Riverdale, MD4 days ago $41.2 - $62.17 per hour
Job Description: The RN Hospital Care Manager I delivers comprehensive care management services to designated patients, leveraging clinical expertise... ...policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to...Hourly payRemote work- ...LTSS Service Coordinator - RN Clinician Anticipated End Date: July 20, 2025 Location... ...RN Clinician is responsible for overall management of member's case within the scope of... ...a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily...Contract workTemporary workWork at officeLocal area1 day per week
$8,015 - $10,844 per month
...then you may be the person we’re seeking for our next Project Manager! What you'll be doing... As a Project Manager, you will be... ...document successes & lessons learned This position has a hybrid work schedule with 3 days per week (Tue, Wed & Thu) on-site in...For contractorsLocal area3 days per weekNorthwest Administrators, Inc
Washington DC4 days ago- ...What you will do Senior Sourcing Manager (Hybrid) will provide leadership of strategic sourcing activities for PCBAs and High-Level Assemblies. You will obtain the best quality, service, and value for products and services through effective bidding, negotiation, and...Full timeContract workWork from homeShift work3 days per week1 day per week
Stryker
Washington DC6 days ago - Universal Health Services (UHS) is seeking a role focused on monitoring insurance denials and coordinating appeal strategies across facilities. The position requires collaboration with HIM, clinicians, and other departments to build strong case documentation. Success depends...
$89.65k - $152.4k
...while building a great career at ICF!Job Location: This role has a hybrid work schedule with some telework, and is based in Alexandria,... ....Provide technical and program support to program directors managing an R&D portfolio of awardees.Assist with management of awardees...Full timeContract workFor contractorsWork experience placementWork at officeRemote workICF
Alexandria, VA3 days ago- ...Project Manager, HR – hybrid | 1064635 Washington DC, Washington DC Area Contract Posted 09/23/2026 Job Description OUR GOAL: Treat our consultants and clients the way we would like others to treat us!Interested in joining our team? Check out...Contract workFor contractors
Revel IT
Washington DC16 days ago $135k - $165k
...The Work: As a Senior Project Manager , you will support Chinook's government-focused clients by coordinating and delivering engineering... ..., both internal and external. In this role, you will work a HYBRID schedule, with a minimum of three days per week at the client...Full timeContract workFor contractorsWork at office3 days per weekChinook Systems
Arlington, VAa month ago- ...Job Description Job Description Role: Senior Project Manager Client: DC Government Location: Washington, DC (Hybrid) Job Description: Key Responsibilities • Ensure full SDLC compliance for all DCAS projects (JAR, design, QA, UAT, OCM, readiness). •...Work at officeLocal area
GoIntellects Inc.
Washington DCa month ago - ...Senior Project Manager SAP ECC and SAP S/4HANA Location: WASHINGTON, District of Columbia (Hybrid 3 days on Site) Duration: 7 Months Rate: DOE U.S. Citizens and those who are authorized to work independently in the United States are encouraged to apply. We are...Immediate start
$90k - $110k
...headquartered in Washington, D.C. The firm is seeking a Project Manager to provide high-level management, administrative and legal... .... Willingness to work occasional overtime to meet deadlines. Hybrid Work Arrangement This role follows a hybrid work model. Hybrid...Local area- ...open requests into an orderly, on-time production line. You will manage workflows, ensure copyediting and accessibility tagging, and... ...emphasizes triage, timeline building, and process improvements, with a hybrid schedule reporting three days weekly to Chevy Chase, MD HQ. #J-...
- ...capabilities for our prime contractor and government customers.This is a hybrid role offering significant work-from-home (WFH) flexibility,... ...program activities, team coordination, and day-to-day sprint management.On-Site Requirements: Occasional travel or on-site presence in...Full timeFor contractorsFor subcontractorRemote workWork from homeFlexible hours
Maxar Technologies
Arlington, VA2 days ago $130k - $135k
...Position Title: Capture Manager (Hybrid) 2026-1473 | VP Business Development (Hybrid) 2026-1478 Location: Bethesda, Maryland, United States Job Category: Business Development Job Type: Full-Time Description: Overview Are you looking to make...Full timeContract workFor contractorsFor subcontractorWork at officeLocal areaVisa sponsorshipWork visaFlexible hoursSedgwick Government Solutions
Bethesda, MD6 days ago$80k - $105k
...Permanent Staff Manager Registered Nurse Job in Washington, DC. Job Details Profession: Registered Nurse Pay: $80000 to $105000 per year Schedule: , 0-Hour 00:00 - 00:00 Openings: 1 Facility & Unit Information ~ Facility Type: Home Health Settle...Daily paidPermanent employmentZero hours contractStart working todayShift workAya Healthcare
Washington DC13 days ago- ...Nursing Manager/Director This role requires oversight of nursing operations within the designated unit. Candidates should possess a valid RN license. Prior oncology experience is strongly preferred. Experience in outpatient settings is ideal. The position does not require...Weekend work
- ...Case Manager IIThe Case Manager II will provide case management services to patients and their families or caregivers. Assist with assessment... ...own practice. Children's National supports the development of RN relationships within the community; specifically those...
IntelyCare
Washington DC5 days ago $89.07k - $162.8k
...General Summary of Position Coordinates negotiates procures and manages care of our members/enrollees to facilitate cost effective care... ...experience required Licenses and Certifications RN - Registered Nurse - State Licensure and/or Compact State Licensure...Contract workWork at officeMedStar Health
Washington DC3 days ago$87.17k - $145.27k
...Case Manager II Kids Are Our Everything. Pay Range: $87,172.80 - $145,267.20 Shift: Monday-Friday 8:30a-5p (some weekends & holidays) Case Managers work within all areas of Children's National including Inpatient Units, Psychiatry, PACU, ED, Children's Health...Work experience placementMonday to FridayShift workWeekend workChildren's National Health System
Washington DC3 days ago- ...Job Description Job Description NURSE CARE MANAGER ACCfamily is a leader in the home care field for the elderly, located in Alexandria, and serving the Northern Virginia and Maryland Area. The duties will include the completion of an assessment of the clients...Flexible hours
ACCfamily
Alexandria, VAa month ago - ...services within given authority and guidelines. • Provides case management supportive functions such as client advocacy, assistance,... ...position requires an ability to perform office functions in a hybrid work model. Work is performed indoors in an office environment,...Work at officeLocal areaWeekday work
Lewis Mason Thurston Area Agency on Aging
Washington DC11 days ago $75k - $100k
...responsibilities include partnering with Program Directors and Managers to advance programmatic goals, monitoring program budgets in collaboration... ...and weekends as needed. Location: Washington D.C. - Hybrid Salary Range: $75,000.00 - $100,000.00 Benefits:...Temporary workWork experience placementLocal areaAfternoon shiftThe HR Team
Washington DC13 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to RN Manager Grievances & Appeals - Hybrid. Be the first to apply!
Related searches
- sedation rn Washington DC
- circulating rn Washington DC
- wound rn Washington DC
- contingent rn Washington DC
- laser rn Washington DC
- rn per diem nurse Washington DC
- charge registered nurse Washington DC
- med surg rn travel contract Washington DC
- part time registered nurse Washington DC
- corrections rn Washington DC