- Molina Healthcare (Atlanta, GA)
- … decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making...these guidelines. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
- CVS Health (Atlanta, GA)
- …zone of residence. **Position Summary** Responsible for the review and resolution of clinical appeals . Reviews documentation and interprets data obtained from ... . **Required Qualifications** + Must have active and unrestricted RN licensure in state of residence + 3+ years... licensure in state of residence + 3+ years clinical experience **Preferred Qualifications** + Appeals Experience… more
- Molina Healthcare (Atlanta, GA)
- …identifying opportunities for improvement. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... the right time and assisting them to achieve optimal clinical , financial, and quality of life outcomes. + Responsible... Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of … more
- Molina Healthcare (Atlanta, GA)
- …resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training and support to clinical ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more