Ohio Licensed Clinical Appeals Nurse

Job Summary

A company is looking for a Clinical Appeals Nurse to manage clinical appeals and state hearings remotely.

Key Responsibilities

• Complete clinical appeals and state hearings from all states within required timeframes
• Prepare State Hearing packets and communicate with state agencies and internal departments
• Maintain documentation accuracy and conduct appeals reporting

Required Qualifications

• Bachelor's degree in Finance, Business, Economics, Engineering, or a valid RN License is required
• Associates Degree or equivalent relevant experience is required
• Managed care, appeals, and Medicaid experience preferred
• Utilization review experience is strongly preferred
• Current, unrestricted RN license and MCG Certification required within six months of hire