Job is Expired
Location: Arizona, Colorado, Connecticut, Florida, Georgia, Indiana, Kansas, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Mississippi, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, West Virginia, Wyoming
Compensation: To Be Discussed
Staff Reviewed: Thu, May 05, 2022
Job Summary
A health insurer is in need of a Remote A and G Clinical Specialist Registered Nurse.
Core Responsibilities Include:
- Case development and resolution of clinical cases
- Preparing cases for Maximus Federal Services, Fair Hearing, and External Appeal through all levels of the appeal process
Position Requirements Include:
- RN or LPN
- Experience in clinical practice with experience in appeals & grievances
- Demonstrated understanding of Utilization Review Guidelines
