California Licensed Appeals RN

Job Summary

Providing patient-focused management of clinically-based appeals, the per diem California Licensed Appeals RN will work remotely, handling communication between Providence Health and Services and outside payers while advocating for reimbursement of services.

Key responsibilities:

• Manage and communicate appeals related to patient care between Providence Health and outside payers
• Ensure compliance and uniformity in the appeals process to support effective patient advocacy
• Collaborate with healthcare teams to facilitate the reimbursement of services provided to patients

Required qualifications:

• Associate's Degree in Nursing
• California Registered Nurse License upon hire
• 4 years of direct patient care experience in an acute hospital setting
• 4 years of experience as a case manager in an acute hospital setting