Appeals RN - Care Management Full- time - REMOTE
About The Position
The Care Management Recovery Advocate (CMRA) is responsible for providing overall management and communication of clinically-based appeals between Providence Health and Services, California Region (PH&S) outside payers. Activities will be patient-focused, uniform, compliant, and support steadfast advocacy for reimbursement of services provided to patients served within the PH&S ministries. Responsibilities are not limited to, but will include: Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence California Regional Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
Requirements
- Associate's Degree - Nursing.
- California Registered Nurse License upon hire.
- 2 years - Direct patient care experience in an acute care setting. Other direct patient care experience may considered (in lieu of acute care).
- 2 years - Experience as a case manager in an acute care setting.
Nice To Haves
- Bachelor's Degree - Nursing or, Master's Degree - Nursing.
- Case management certification upon hire.
- Experience working with denials and appeals in/for an acute care setting.
- Experience in a multi-hospital and/or integrated healthcare system.
Benefits
- Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security.
- We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
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What This Job Offers
Job Type
Full-time
Education Level
Associate degree
Number of Employees
5,001-10,000 employees
