Remote Appeals Nurse Consultant

Job ID: Available for Members

Location: Arkansas, Connecticut, Missouri, North Carolina, Pennsylvania, Virginia

Compensation: To Be Discussed

Staff Reviewed: Wed, Apr 03, 2019

Job Category: Healthcare, Nursing

Telecommute Level: Majority

Travel Requirements: Field Travel Required, Some Travel

Weekly Hours: Full Time

Employer Type: Employer

Career Level: Experienced

Education Level: Some College

Job Summary

A healthcare company needs applicants for an opening for a Remote Appeals Nurse Consultant.

Core Responsibilities of this position include:

  • Reviewing clinical appeals from participating inpatient and outpatient Medicare Advantage providers
  • Making medical necessity recommendations based on industry standards, MCG or InterQual guidelines
  • Reviewing clinical appeals from participating inpatient and outpatient Medicare Advantage providers

Must meet the following requirements for consideration:

  • 0-10% travel
  • 3-5 years of clinical experience
  • Nursing/Registered Nurse License in the State of Residence