Grievance and Appeals Nurse
9 hours ago
HealthCare Support is seeking a skilled Grievance and Appeals Nurse to fill a hybrid role with a top 25 Managed Care Company in Rancho Cucamonga, CA.
Key Responsibilities:
- Work closely with the Grievance and Appeals Team to investigate and resolve Member grievances.
- Review case coding and assist in the resolution of Member medical issues.
- Coordinate care with practitioners, providers, and entities/agencies involved in the Member's care.
Requirements:
- High school diploma or GED
- Clear and active LVN license in CA
- 2+ years of Case Management, Grievances and Appeals, and/or Utilization Management experience from an MCO setting
- Valid California Driver's License
Preferred Qualifications:
- Bachelor's degree
- HMO experience
Benefits:
- Immediate enrollment in Health Insurance
- Dental Insurance
- Life Insurance
- Employee Assistance Program (EAP)
- Access to Investment Accounts
- Career and educational tools within our Ingenovis ACT (Advocacy) Program
Pay Details:
$31 an hour flat rate
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