- Molina Healthcare (Austin, TX)
- … 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
- Molina Healthcare (TX)
- …Practical Nurse in good standing. **Preferred Education** Completion of an accredited Registered Nurse ( RN ) Program or a bachelor's degree in Nursing. ... contained in the delegation agreement. **KNOWLEDGE/SKILLS/ABILITIES** The **Delegation Oversight Nurse ** is responsible for ensuring that Molina Healthcare's UM… more
- HCA Healthcare (San Antonio, TX)
- …of Hospice and /or relevant end of life care experience preferred. + Licensed as a Registered Nurse in the state(s) in which he/she will be providing services. + ... 156,000 hours impacting our communities. As a Director of Clinical Services with Methodist Hospice & Family Care, you...audits and oversight of adverse events. Assists with processing appeals and denials as requested. + Provides a lead… more
- HCA Healthcare (Arlington, TX)
- …Works with subject matter experts (eg Operations, Education, Centers for Clinical Advancement, Survey Readiness, Regulations, Compliance, Appeals team) to ... hours impacting our communities. As a Hospice Director of Clinical Operations with HCA Hospice and Family Care, you...software and virtual meeting platform experience required. + Valid RN license within practice state required. + Certified Hospice… more
- Houston Methodist (Sugar Land, TX)
- …performance that demonstrates progressive leadership abilities **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure ... and/or Compact State Licensure within 60 days **OR** + RN -Temp - Registered Nurse -...**AND** + Magnet - ANCC Recognized Certification -- If RN within 1 year + LCSW- License Clinical… more
- Centene Corporation (Austin, TX)
- …organization preferred LPN - Licensed Practical Nurse - State Licensure required or RN - Registered Nurse - State Licensure and/or Compact State ... & objectives of Corporate and health plans. + Provide coding/ clinical decisions on first time claims, adjustments and ...clinical decisions on first time claims, adjustments and appeals in accordance with correct coding guidelines and Centene… more