Massachusetts Licensed Appeals Nurse

Location: Remote

Compensation: To Be Discussed

Reviewed: Tue, May 05, 2026

This job expires in: 23 days

Job Category: Healthcare

Weekly Hours: Full Time

Employment Status: Permanent

Employer Type: Employer

Career Level: Experienced

Education Level: Bachelors

Job Summary

A company is looking for an Appeals and Grievances Nurse.

Key Responsibilities

Ensure timely resolution of clinical/pharmacy appeals and grievances to meet regulatory timeframes
Review clinical/pharmacy appeal cases and provide recommendations based on analysis of clinical material
Track and monitor the status of appeals and grievances, identifying trends for quality improvement initiatives

Required Qualifications

Bachelor's Degree in Nursing required
Massachusetts Registered Nurse (RN License) required
3-5 years of experience in clinical appeals, grievances, or related healthcare services required
2-3 years of clinical experience required

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