New York City or Lake Mary or New York or North Dakota or Indiana or Virginia or Texas or Tennessee or South Carolina or Pennsylvania or Ohio or Nevada or New Jersey or North Carolina or Minnesota or Maryland or Massachusetts or Kansas or Illinois or Iowa or Georgia or Florida or Delaware or Connecticut or Colorado or New Hampshire or Vermont or Arizona or Alabama or Maine or Utah or Mississippi or Montana or South Dakota or Nebraska or New Mexico or Washington or Michigan or Oklahoma
$73k-$120k/yrRemoteFull Time
Healthfirst: Provides not-for-profit health insurance coverage to New York residents.
Active registered nurse (rn) required; experience in appeals & grievances, utilization review, claims processing preferred; familiarity with Utilization Review guidelines and care management systems; strong documentation and case management skills.
Microsoft Word, Microsoft Excel, Macess, CCMS, TruCare, Hyland, InterQual, Milliman
New York or West Virginia or North Dakota or Wisconsin or Indiana or Virginia or Texas or Tennessee or South Carolina or Pennsylvania or Ohio or Nevada or New Jersey or North Carolina or Minnesota or Maryland or Massachusetts or Florida or Delaware or Connecticut or New Hampshire or Arizona or Vermont or Alabama or Maine or Wyoming or Montana or South Dakota or Nebraska or New Mexico or Washington or Michigan or Hawaii or Oklahoma
$73k-$120k/yrRemoteFull Time
Healthfirst: Provides not-for-profit health insurance coverage to New York residents.
LPN or RN required; experience in clinical practice and appeals & grievances, claims processing, utilization review preferred. Knowledge of Utilization Review guidelines, InterQual or Medicare guidance; proficiency with Microsoft Word and Excel.
Microsoft Word, Microsoft Excel, Macess, InterQual