Clinical Appeals RN - Cypress, CA

The Clinical Appeals RN is responsible for providing expertise in clinical appeals and grievances (analyzing, reviewing, and evaluating appeals and grievances), and acting as a Clinical Interface Liaison (clinical problem solver with facilities, providers, carriers resolution of ...

This position follows a hybrid schedule with three (3) days in-office days per week. At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of peop ...

This position follows a hybrid schedule with three (3) days in-office days per week (potentially more). Our office is located at 5701 Katella Ave., Cypress, CA 90630. · At UnitedHealthcare, we're simplifying the health care experience, · The Clinical Appeals Representative needs ...

· SUMMARY · The Clinical Appeals Nurse is responsible for investigating and processing medical necessity appeals from members and providers to payers. Possesses the ability to conduct research on standards or practice, regulations, and policy relevant to any case. Responsible fo ...

· SUMMARY · The Clinical Appeals Nurse is responsible for investigating and processing medical necessity appeals from members and providers to payers. Possesses the ability to conduct research on standards or practice, regulations, and policy relevant to any case. Responsible fo ...

SUMMARY · The Clinical Appeals Nurse is responsible for investigating and processing medical necessity appeals from members and providers to payers. Possesses the ability to conduct research on standards or practice, regulations, and policy relevant to any case. Responsible for o ...

The Clinical Review Nurse evaluates medical records and clinical documentation to support the resolution of claims member grievances appeals and quality-of-care concerns. · ...

The Clinical Review Nurse evaluates medical records and clinical documentation to support the resolution of claims, member grievances, appeals, and quality-of-care concerns.Using clinical judgment and appropriate application of CMS regulations, Medicare Advantage requirements, an ...

We are seeking a Clinical Review Nurse to evaluate medical records and clinical documentation to support the resolution of claims, member grievances, appeals, and quality-of-care concerns.The Clinical Review Nurse applies clinical acumen to assess medical necessity, appropriatene ...

The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies. · Performs individual case review for appeals and grievances for various health plan and insurance pr ...

The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. · Perform individual case review for appeals and grievances for various health plan and insurance produ ...

The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies.You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some toug ...

The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. · Caring. Connecting. Growing together. · Work at home · The Appeals and Grievances Medical Director is ...

The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies. · Perform individual case review for appeals and grievances for various health plan and insurance pro ...

+Job summary · Caring. Connecting. Growing together · Work at home. · The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies.+MD or DO with an active, unrest ...

The Appeals Medical Director will perform ongoing clinical review and adjudication of appeals cases for UnitedHealthcare associated companies. · MD or DO with an active license. · ...

The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies. · You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some t ...

The work you do here impacts the lives of millions of people for the better. · Perform individual case review for appeals and grievances for various health plan and insurance products. · Communicate with UnitedHealthcare medical directors regarding appeals decision rationales, an ...

The work you do here impacts the lives of millions of people for the better. · Come build the health care system of tomorrow, making it more responsive, affordable and optimized. · You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some t ...

The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies. You will perform individual case review for appeals and grievances for various health plan and insura ...