Grievance And Appeals Nurse Specialist
Found in: beBee S US - 1 week ago
- Job Title: Grievance and Appeals Nurse Specialist
- CalOptima Health is seeking a highly motivated an experienced TEMP - Grievance & Appeals Nurse Specialist to join our team.
- The Grievance and Appeals Nurse Specialist participates in managing CalOptima Healths medical appeals and state hearing reviews for all lines of business, including handling expedited and standard requests.
- The incumbent will clearly articulate the facts and CalOptima Healths position regarding disputes to the Administrative Law Judge hearing the case.
- Presents recommendations based on clinical review, criteria and organizational policies to CalOptima Healths physician reviewers for final determination.
- Assigns position statements and represents CalOptima Health at state hearings.
- Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Farsi, Chinese, Korean, Spanish, Vietnamese).
- Active Licensed Vocational Nurse (LVN) license to practice in the state of California required.
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Grievance And Appeals Nurse Specialist
Found in: beBee jobs US - 2 weeks ago
Orange, California, United States V Group Inc Full timeJob Title: Grievance and Appeals Nurse SpecialistCalOptima Health is seeking a highly motivated an experienced TEMP - Grievance & Appeals Nurse Specialist to join our team.The Grievance and Appeals Nurse Specialist participates in managing CalOptima Healths medical appeals and state hearing reviews for all lines of business, including handling expedited and...
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Found in: Appcast Linkedin GBL C2 - 7 hours ago
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