Massachusetts Licensed Clinical Nurse

Job is Expired

Location: Remote

Compensation: To Be Discussed

Reviewed: Sat, Jun 21, 2025

Job Category: Healthcare

Weekly Hours: Part Time

Employment Status: Permanent

Employer Type: Employer

Career Level: Experienced

Education Level: Bachelors

Job Summary

A company is looking for a Clinical Appeal and Grievance Nurse, part-time.

Key Responsibilities

Ensure timely resolution of clinical/pharmacy appeals and grievances to meet regulatory timeframes
Interact with providers and members to gather clinical information and understand appeals
Review clinical/pharmacy appeal cases and provide recommendations to the medical director team

Required Qualifications

Bachelor's Degree required
Massachusetts Registered Nurse (RN) required
3-5 years of experience in clinical appeals, grievances, or related healthcare services required
2-3 years of clinical experience required
Experience with multiple data systems preferred

COMPLETE JOB DESCRIPTION

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Job is Expired

Company Overview

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