Talent.com
Maryland Licensed Clinical Appeals Nurse

Maryland Licensed Clinical Appeals Nurse

VirtualVocationsBurlington, Vermont, United States
8 hours ago
Job type
  • Full-time
Job description

A company is looking for a Clinical Appeals Nurse (Remote).

Key Responsibilities

Investigates and analyzes written appeals and reconsideration requests, responding with detailed letters while adhering to corporate policies and regulations

Organizes appeal cases for physician review, compiling relevant information and communicating final decisions to members and providers

Utilizes nursing expertise to prioritize and assess appeal requests related to medical and behavioral health conditions, collaborating with external review organizations as necessary

Required Qualifications

High School Diploma or GED

Registered Nurse (RN) State Licensure required upon hire

2 years of medical-surgical or similar clinical experience, or 3 years in a mental health setting

Certified Case Manager (CCM) and / or Legal Nurse Consultant Certified (LNCC) preferred upon hire

Preferred BSN or MSN degree

Create a job alert for this search

Licensed Clinical • Burlington, Vermont, United States

Related jobs
  • Promoted
Respiratory Care Practitioner II (Hiring Immediately)

Respiratory Care Practitioner II (Hiring Immediately)

University of Vermont Health - UVM Medical CenterBurlington, VT, US
Full-time
We are the heart and science of medicine.The Pulmonary Function Technologist II (PFT) independently provides all modes of pulmonary function testing as ordered by a physician, assists with bronchos...Show moreLast updated: 8 days ago
  • Promoted
Care Coordinator

Care Coordinator

VirtualVocationsBurlington, Vermont, United States
Full-time
A company is looking for a Care Coordinator in the Mountain Time Zone.Key Responsibilities Engage and enroll patients through telephonic outreach, serving as their primary contact Develop and im...Show moreLast updated: 30+ days ago
  • Promoted
Patient Engagement Advocate

Patient Engagement Advocate

VirtualVocationsBurlington, Vermont, United States
Full-time
A company is looking for a Patient Engagement Center Advocate.Key Responsibilities Respond to incoming phone calls and schedule patient appointments in the EMR system Document patient requests a...Show moreLast updated: 30+ days ago
  • Promoted
Respiratory Care Practitioner (Hiring Immediately)

Respiratory Care Practitioner (Hiring Immediately)

University of Vermont Health - UVM Medical CenterBurlington, VT, US
Full-time
We are the heart and science of medicine.The Pulmonary Function Technologist II (PFT) independently provides all modes of pulmonary function testing as ordered by a physician, assists with bronchos...Show moreLast updated: 8 days ago
  • Promoted
Behavioral Health Social Worker (Hiring Immediately)

Behavioral Health Social Worker (Hiring Immediately)

SENIOR CARE THERAPYPlattsburgh, NY, US
Full-time +1
Licensed Clinical Social Worker LCSW.Are you passionate about working with an underserved and rewarding population? Looking for a clinical role without the administrative burden, and one that offer...Show moreLast updated: 9 days ago
  • Promoted
Per Diem Remote Nurse Practitioner - Substance Use Disorder

Per Diem Remote Nurse Practitioner - Substance Use Disorder

BayMark Health Services CareersSt. Albans, Vermont, US
Remote
Full-time
Per Diem (Remote) Nurse Practitioner / Physician Assista.Remote Locations to Serve : Bennington / Berlin / Newport / St.BAART Treatment Centers are dedicated to providing individualized treatment integratin...Show moreLast updated: 14 days ago
  • Promoted
Healthcare - Practical Nursing Specialist

Healthcare - Practical Nursing Specialist

U.S. Army Recruiting - Albany BattalionPlattsburgh, New York, US
Full-time +2
THIS POSITION REQUIRES AN ENLISTMENT IN THE U.Make sure to apply quickly in order to maximise your chances of being considered for an interview Read the complete job description below.As a Practica...Show moreLast updated: 30+ days ago
  • Promoted
Licensed Care Management Nurse / Social Worker

Licensed Care Management Nurse / Social Worker

VirtualVocationsBurlington, Vermont, United States
Full-time
A company is looking for a Care Management Nurse or Social Worker.Key Responsibilities Collect and assess in-depth information about member situations to identify needs and develop specific care ...Show moreLast updated: 14 days ago
  • Promoted
Non-Clinical Case Manager

Non-Clinical Case Manager

VirtualVocationsBurlington, Vermont, United States
Full-time
A company is looking for a Non-Clinical Case Manager to provide patient support remotely during the hours of 11-8p EST, M-F. Key Responsibilities Provide virtual support to patients, case managers...Show moreLast updated: 30+ days ago
  • Promoted
State Licensed Utilization Review Nurse

State Licensed Utilization Review Nurse

VirtualVocationsBurlington, Vermont, United States
Full-time
A company is looking for a Utilization Review Nurse (PRN).Key Responsibilities Review and evaluate electronic medical records for emergency admissions to assess medical necessity Apply clinical ...Show moreLast updated: 30+ days ago
  • Promoted
South Carolina Licensed RN Case Manager

South Carolina Licensed RN Case Manager

VirtualVocationsBurlington, Vermont, United States
Full-time
A company is looking for an RN Concierge Care Manager - Case Manager.Key Responsibilities Direct day-to-day high-touch member management, including treatment plan coordination for high-risk popul...Show moreLast updated: 1 day ago
  • Promoted
Neurosurgery Outpatient Nurse Practitioner

Neurosurgery Outpatient Nurse Practitioner

Beth Israel Lahey HealthBurlington, US
Full-time
Join Lahey Hospital & Medical Center, a premier healthcare organization in Massachusetts, as a full-time, experienced Nurse Practitioner to join our expanding Neurosurgery team.We are look...Show moreLast updated: 30+ days ago
  • Promoted
Pulmonary Care Practitioner (Hiring Immediately)

Pulmonary Care Practitioner (Hiring Immediately)

University of Vermont Health - UVM Medical CenterBurlington, VT, US
Full-time
We are the heart and science of medicine.The Pulmonary Function Technologist II (PFT) independently provides all modes of pulmonary function testing as ordered by a physician, assists with bronchos...Show moreLast updated: 8 days ago
  • Promoted
Healthcare - Operating Room Specialist

Healthcare - Operating Room Specialist

U.S. Army Recruiting - Albany BattalionPlattsburgh, New York, US
Full-time +2
THIS POSITION REQUIRES AN ENLISTMENT IN THE U.Increase your chances of reaching the interview stage by reading the complete job description and applying promptly. As an Operating Room Specialist in ...Show moreLast updated: 30+ days ago
  • Promoted
California Licensed Review Nurse

California Licensed Review Nurse

VirtualVocationsBurlington, Vermont, United States
Full-time
A company is looking for a Pre-Service Review Nurse RN to work remotely in the Pacific or Mountain Time Zones.Key Responsibilities Conduct utilization management, including Prior Authorization Re...Show moreLast updated: 1 day ago
  • Promoted
Senior Respiratory Care Practitioner (Hiring Immediately)

Senior Respiratory Care Practitioner (Hiring Immediately)

University of Vermont Health - UVM Medical CenterBurlington, VT, US
Full-time
We are the heart and science of medicine.The Pulmonary Function Technologist II (PFT) independently provides all modes of pulmonary function testing as ordered by a physician, assists with bronchos...Show moreLast updated: 8 days ago
  • Promoted
Acute Care Respiratory Practitioner (Hiring Immediately)

Acute Care Respiratory Practitioner (Hiring Immediately)

University of Vermont Health - UVM Medical CenterBurlington, VT, US
Full-time
We are the heart and science of medicine.This position provides professional respiratory care to patients in varying states of health and illness by assessing, planning, implementing and evaluating...Show moreLast updated: 8 days ago
  • Promoted
Hospitalist PA

Hospitalist PA

Beth Israel Lahey HealthBurlington, US
Full-time
Join our dynamic Hospital Medicine team at Lahey Hospital and Medical Center, a part of Beth Israel Lahey Health, as a skilled and experienced Physician Assistant. Work one-on-one with a team of phy...Show moreLast updated: 30+ days ago
  • Promoted
Advanced Respiratory Care Practitioner (Hiring Immediately)

Advanced Respiratory Care Practitioner (Hiring Immediately)

University of Vermont Health - UVM Medical CenterBurlington, VT, US
Full-time
We are the heart and science of medicine.The Pulmonary Function Technologist II (PFT) independently provides all modes of pulmonary function testing as ordered by a physician, assists with bronchos...Show moreLast updated: 8 days ago
  • Promoted
Respiratory Care Practitioner (Hiring Immediately)

Respiratory Care Practitioner (Hiring Immediately)

University of Vermont Health - Champlain Valley Physicians HospitalPlattsburgh, NY, US
Full-time
Registered Respiratory Therapists deliver both routine and critical care services for the diagnosis and treatment of respiratory dysfunction, including, but not limited to oxygen and aerosol therap...Show moreLast updated: 8 days ago