Appeals RN - Case Management - Per Diem - REMOTE

Providence • Torrance, CA

17h • 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. 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 be 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.
• 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.

Responsibilities

• Providing overall management and communication of clinically-based appeals between Providence Health and Services, California Region (PH&S) outside payers.
• Ensuring activities are patient-focused, uniform, and compliant.
• Supporting steadfast advocacy for reimbursement of services provided to patients served within the PH&S ministries.

Benefits

• Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security.

What This Job Offers

• Career Level: Mid Level
• Education Level: Associate degree