Appeals Jobs

This remote Appeals Pharmacist role within a confidential managed care organization focuses on reviewing and evaluating medication coverage appeals to ensure fair patient access. Key responsibilities include analyzing clinical documentation, applying evidence-based guidelines and regulatory requirements to determine outcomes, and preparing written clinical rationales while collaborating with medical teams. The position is appealing for its opportunity to leverage clinical judgment to advocate for patients and gain specialized expertise in utilization management and appeals processes. It offers a flexible work arrangement and a collaborative environment dedicated to safeguarding patient access while maintaining strict regulatory compliance.

This full-time legal role within the Office of the Attorney General focuses on criminal appellate litigation for the Commonwealth of Virginia. The position involves representing the state in the Court of Appeals and Supreme Court of Virginia, handling habeas corpus and post-trial litigation across state and federal courts, and providing legal advice on criminal procedure and legislative matters. The role appeals to attorneys seeking to impact state justice through high-stakes advocacy and legislative engagement. Key responsibilities include legal research, writing, and oral argument, with some overnight travel required. The position is based at the Office of the Attorney General and requires admission to the Virginia State Bar along with relevant legal experience.

The Clinical Denials Management Program Coordinator RN role operates within Patient Financial Services at a nationally recognized hospital. The position manages clinically based appeals between the organization and external payers while serving as a liaison for Case Management and other departments. Key responsibilities include reviewing denials against InterQual guidelines, constructing clinically oriented appeal letters, tracking denial trends, and developing corrective action plans to reduce future denials. The role also involves providing educational sessions to staff on reimbursement changes and denial prevention strategies. This position is appealing due to the organization's reputation for excellence, its award-winning workplace culture, and a commitment to fostering a dynamic, inclusive environment. The role requires a current California RN license and significant case management experience.

The Senior Vendor Management Professional serves as a liaison between the organization and external vendors within the healthcare sector. Key responsibilities include negotiating contract terms, resolving invoice discrepancies, monitoring vendor performance, and influencing departmental strategy. This role requires managing moderately complex operational issues with a high degree of independence. The position is appealing due to the opportunity to make a tangible impact on consumer health experiences within a caring community. It offers a remote work arrangement with occasional travel for training or meetings, providing flexibility while supporting the mission of improving care for millions of members.

This mid-senior litigation associate role at Mueller Christensen LLP involves managing complex civil and probate cases within a growing boutique firm. Key responsibilities include independently handling written discovery, conducting and defending depositions, drafting and arguing motions, appearing in court, and supervising junior attorneys. The position offers a hybrid work arrangement and appeals to candidates seeking a supportive yet direct culture that values strategic thinking and professional growth. The role provides substantial client contact and opportunities to develop a sophisticated practice in a collaborative environment focused on meaningful legal advocacy.

The Trial Attorney II role within the Chief Disciplinary Counsel department in Houston represents the Texas Commission for Lawyer Discipline during attorney disciplinary proceedings. Key responsibilities include presenting cases before District Grievance Committees, District Courts, and the Board of Disciplinary Appeals while maintaining frequent contact with State Bar departments and outside agencies. This position offers the opportunity to serve the public interest by upholding professional standards within the legal community. The role is based on-site in Houston and involves regular interaction with various legal entities and organizations.

The Program Evaluation and Benefits Specialist role supports AltaPointe's clinical team by assisting adult patients with psychiatric and substance use disorders in navigating complex benefit systems. Key responsibilities include conducting patient assessments, managing clinical documentation within electronic health records, and advocating for community resources to secure necessary care. The specialist also handles crisis de-escalation, coordinates patient placements, and maintains accurate data for grant reporting and performance improvement initiatives. This position appeals to candidates seeking a mission-driven environment where they can directly impact patient stability and recovery. The role requires flexibility to travel to patient homes and collaborate with external agencies, offering opportunities for professional growth through ongoing training and certification support.

The Zoning Code Enforcement Officer role supports community development services for Chikaming Township, MI, within a team of over 1600 professionals. Key responsibilities include investigating code violations, enforcing zoning ordinances, and assisting with building permit reviews. The position requires conducting field inspections, preparing detailed reports, and communicating findings to the public and various stakeholders. This opportunity appeals to motivated self-starters seeking a collaborative culture that values integrity and continuous improvement. The company offers comprehensive career progression through paid training and certification incentives. The work arrangement involves a hybrid schedule split between office duties and field inspections across the region, requiring regular driving and mobility to access construction sites and residential properties.

This full-time role involves a Licensed Mental Health Therapist joining Rula Technologies' healthcare division to deliver personalized mental health services to the tech community. Key responsibilities include conducting individual and group therapy sessions, developing innovative treatment plans that integrate digital aids, and collaborating with the engineering team to customize therapeutic tools. The position requires maintaining accurate electronic records and educating the community on wellness strategies. This opportunity appeals to professionals seeking to combine clinical expertise with technology to expand therapeutic reach. The role offers a unique environment where digital innovation supports holistic care, ideal for those passionate about modernizing mental health practices while working with a forward-thinking team.

This full-time role involves a Licensed Mental Health Therapist joining Rula Technologies' healthcare division to deliver personalized mental health services to the tech community. Key responsibilities include conducting individual and group therapy sessions, developing innovative treatment plans that integrate digital aids, and collaborating with the engineering team to customize therapeutic tools. The position also requires maintaining accurate electronic records and educating the community on wellness strategies. This opportunity appeals to professionals seeking to blend clinical expertise with technology to expand therapeutic reach. The role offers a dynamic environment where practitioners can utilize their state license to drive holistic care outcomes while working with a forward-thinking team focused on digital mental health innovation.

This full-time role involves a Licensed Mental Health Therapist joining Rula Technologies' healthcare division to deliver personalized mental health services to a tech-focused community. Key responsibilities include conducting individual and group therapy sessions, developing innovative treatment plans that integrate digital aids, and collaborating with the engineering team to customize therapeutic tools. The position requires maintaining accurate electronic records and educating the community on wellness strategies. This opportunity appeals to professionals seeking to blend clinical expertise with technology to expand therapeutic reach. The role offers a unique environment for those interested in the intersection of mental health and digital innovation, supporting a holistic approach to well-being while utilizing modern electronic health record systems.

This full-time Licensed Mental Health Therapist role is based within Rula Technologies' healthcare division, focusing on delivering personalized mental health services to the tech community. The position involves conducting individual and group therapy sessions while integrating digital tools to enhance therapeutic outcomes. Key responsibilities include developing innovative therapy plans with digital aids, collaborating with the engineering team to customize technology solutions, and maintaining accurate electronic health records. The role appeals to professionals seeking a holistic approach where technology amplifies the reach and efficacy of mental health care. It offers a unique opportunity to work in a collaborative environment that values innovation, requires an active state license, and supports continuous learning in both clinical practices and digital health trends.

The Employee Relations Investigator role supports the Human Resources department in conducting thorough investigations into low to mid-level risk workplace issues, including harassment, discrimination, and financial concerns. Key responsibilities include collecting and analyzing employment data, preparing unbiased investigative reports, identifying process gaps to mitigate legal liability, and testifying in formal proceedings when required. The position offers a hybrid work arrangement with 80% onsite presence in Durant, Oklahoma, and 20% remote flexibility. This opportunity appeals to professionals seeking to apply their knowledge of employment laws in a collaborative environment where they can build trust-based relationships and contribute to organizational integrity through fair and impartial resolution of sensitive employee matters.

The Production Supervisor role for the Lamination department oversees the 2nd shift operations at LEER Group, a leading manufacturer of fiberglass and aluminum truck caps. This position manages a team of approximately 60 employees across gel and mold preparation, lamination, and finishing processes. Key responsibilities include coordinating daily production schedules, ensuring product quality and safety compliance, managing hazardous waste protocols, and applying lean manufacturing principles to drive efficiency. The role appeals to candidates seeking a leadership position within a stable, family-owned company that values team development and a culture of continuous improvement. The position requires a hands-on approach in a fast-paced environment with occasional flexible scheduling to meet production demands.

The Student Services Center Specialist role serves as a central liaison within the university to support students and prospective applicants across multiple departments. Key responsibilities include managing student records, advising on admissions and financial aid processes, and coordinating with offices such as the Registrar and Business Office to resolve complex student issues. The position requires proficiency in student information systems and maintaining strict confidentiality. This opportunity appeals to those seeking a collaborative environment focused on student success, offering professional development and the chance to make a direct impact on the academic journey of the campus community.

This management role within the Health Information Management department oversees Clinical Documentation Integrity and education across the Hartford HealthCare system. The position involves leading a team of specialists to manage audits, prevent revenue denials, and ensure regulatory compliance with Medicare and coding standards. Key responsibilities include developing staff education programs, analyzing performance metrics, and collaborating with revenue cycle leadership to improve data quality and patient safety reporting. The role appeals to experienced nursing professionals seeking career growth within a comprehensive healthcare network that values innovation and work-life balance. The position requires travel between facilities and offers the opportunity to influence system-wide clinical documentation strategies.

This remote Utilization Management Nurse role supports Alignment Health's mission to serve seniors and chronically ill patients by reviewing pre-service authorization requests for medical necessity. The position requires an active California RN or LVN license and involves applying CMS and Milliman Care Guidelines to determine coverage for inpatient and outpatient services. Key responsibilities include collaborating with providers and medical directors, verifying eligibility and coding accuracy, and managing turnaround times for referrals. The role appeals to nurses seeking a fast-paced, production-driven environment with opportunities for professional growth within a mission-driven company. The schedule is Monday through Friday with occasional weekend rotations, operating within Pacific, Mountain, or Central time zones.

The Staff Attorney role at Catholic Charities' St Frances Cabrini Center focuses on providing direct legal representation to unaccompanied immigrant children and families in the Houston-Galveston area. Key responsibilities include managing a high-volume caseload of immigration matters before USCIS and courts, conducting client intakes and legal research, and leading community outreach efforts in both English and Spanish. The position also involves supervising legal assistants and law student interns while ensuring strict compliance with grant reporting requirements. This opportunity appeals to attorneys seeking to serve vulnerable populations within a supportive, family-friendly organization that values diversity and professional growth. The role requires a Texas bar license and bilingual proficiency, offering a chance to make a meaningful impact in immigration law while working as part of a collaborative legal team.

This full-time supervisory role within the Colorado Division of Youth Services oversees direct care staff at the Mount View Youth Service Center. The position involves managing daily facility operations, including staff scheduling, youth movement, security protocols, and crisis intervention. Key responsibilities include mentoring and evaluating subordinate Youth Services Specialists, ensuring compliance with trauma-responsive care standards, and facilitating educational and behavioral programming for youth. The role appeals to candidates seeking to lead a dedicated team in a mission-driven environment focused on rehabilitation and safety. The position requires on-site presence at the facility and offers opportunities for professional growth through reflective supervision and specialized training in juvenile justice practices.

This full-time State Regulatory Veterinarian role within the Colorado Division of Racing focuses on ensuring equine welfare and sports integrity. The position involves conducting pre-race medical inspections to determine horse fitness, overseeing laboratory drug screening programs, and managing the Test Barn staff. Key responsibilities include collaborating on disease control, participating in postmortem research, and representing the division in administrative hearings. The role appeals to candidates passionate about animal health and public service, offering the opportunity to shape industry regulations and mentor a dedicated team. The position is onsite with travel required between the Lakewood office and Arapahoe Park, providing a dynamic environment for professional growth in a mission-driven government agency.

The Development Operations and Communications Manager role at Daniel Defense supports the organization's nonprofit initiatives through strategic fundraising and communication planning. Key responsibilities include executing annual fundraising campaigns, managing donor communications and database accuracy, and collaborating with marketing teams to create promotional materials. The position leverages digital tools to analyze campaign performance and align fundraising efforts with broader organizational goals. This opportunity appeals to candidates seeking a mission-driven environment where they can utilize their project management and relationship-building skills. The role offers a comprehensive benefits package including health insurance and retirement planning, supporting a dedicated professional in a leadership capacity within a respected manufacturing company.

The Development, Communications and Strategic Partnerships Manager leads the agency's fundraising, marketing, and public relations efforts in collaboration with the board and community volunteers. Key responsibilities include developing comprehensive fundraising strategies, managing signature events and donor campaigns, and cultivating strategic partnerships with local institutions across multiple counties. The role also involves overseeing volunteer recruitment, managing marketing budgets, and ensuring adherence to professional fundraising ethics. This position is appealing for its mission-driven focus on supporting individuals in crisis within the Big Bend region, offering a collaborative environment that values creativity and community engagement. The organization provides a comprehensive benefits package including fully paid health insurance, retirement plans, and professional development opportunities.

The Assistant City Attorney/Prosecutor role operates within the Office of the City Attorney under the direction of the City Attorney. This position handles complex legal casework involving the prosecution of criminal and civil violations of state and city laws. Key responsibilities include screening potential cases, evaluating evidence, drafting legal documents such as warrants and complaints, and representing the City in court proceedings, administrative hearings, and appeals. The role also involves providing legal advice to city departments and supervising representation in administrative enforcement actions. This position appeals to legal professionals seeking to serve the public interest while developing expertise in municipal law. The role requires a Juris Doctor degree, Utah State Bar membership, and strong skills in legal writing and oral advocacy.

The Director of Compliance - RN role leads the organization's adherence to federal and state healthcare regulations within a hospice setting. This position partners with executive leadership to audit operations, manage CMS survey processes, and oversee physician credentialing. Key responsibilities include developing policies, chairing the QAPI and Compliance Committee, and driving data-driven quality improvement initiatives. The role appeals to experienced nursing leaders seeking to shape organizational excellence in a mission-driven environment. The position requires a current Arkansas RN license and offers the opportunity to influence care standards while working with a collaborative leadership team.

The Medical Director, Medical Management role at Highmark Inc. leads a physician team responsible for ensuring utilization management aligns with current clinical standards. Key duties include conducting electronic reviews of escalated cases to determine medical necessity, engaging in peer-to-peer discussions, and advising multidisciplinary teams on complex care scenarios. The position also involves developing clinical protocols and managing special projects to improve member care. This opportunity appeals to physicians seeking to impact population health within a collaborative environment that values critical thinking and professional growth. The role is primarily office-based with occasional travel up to 25 percent.