Grievance and Appeals Nurse LVN

Job DescriptionJob DescriptionThe Grievance and Appeals Nurse Specialist participates in managing organization medical appeals and state hearing reviews for all lines of business, including handling expedited and standard requests. The LVN will ensure appeals and state hearing requests are processed in accordance with regulations, compliance standards and policies and procedures. The LVN will investigate and prepare case narratives and statements of position based on clinical information, benefits and applicable regulations related to member or provider disputes of decisions. The LVN will be responsible for creating and reviewing resolution letters for appropriateness of clinical criteria and regulatory requirements.

Minimum Qualifications:

- High School diploma required.
- 5 years of health care/managed care experience required. Preferably in the following related areas of responsibility: Grievances and Appeals, Utilization Management and/or Quality Management.
- An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above is also qualifying.

Preferred Qualifications:

- Active Registered Nurse (RN) license to practice in the state of California.
- Bilingual in English and in one of COMPANY's defined threshold languages (Arabic, Farsi, Chinese, Korean, Spanish, Vietnamese).

Required Licensure / Certifications:

- Active Licensed Vocational Nurse (LVN) license to practice in the state of California required.

EEO/AA Employer/Vet/Disabled.

The Know Your Rights poster is available here:
https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12.pdf

The pay transparency policy is available here:
https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf

For temporary assignments lasting 13 weeks or longer, the Company is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.

We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.

ALL's WELL participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.
https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf

We also consider qualified applicants regardless of criminal histories, consistent with legal requirements. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

#8822

Company DescriptionFinding the career that fits you best can feel like putting together pieces of a puzzle. You’re not always sure what’s the right choice to make, and might want some guidance along the way. What you need is an expert who’s seen it all before, someone who has the best insight, and can lend you a few tips along the way. That’s where your dedicated All’s Well Hiring Advisor comes into the picture.

We don’t just introduce you to a job opportunity, we present you with a selection of tailored careers among the thousands of employers within our network.

Healthcare Staffing Made HumanTM

The hiring advisors at All’s Well know just how difficult it can be to find a fitting career. And it is made worse when you aren’t getting the communication you deserve. We have a great deal of respect for your time, and know that the best way to honor it is by giving you results and feedback directly.

You are More Than Just a Resume

A single piece of paper can’t possibly communicate how unique and amazing you are. We take the time to find out what really makes you tick, and do everything we can to understand all the things that make you the right fit for an employer.

We Will Market You

We will act as a PR firm that is dedicated just to you. Our personal interviews and assessments are designed to create as many talking points into your profile as possible, making you all that more attractive to our client companies.

Our Network is Your Network

After you’ve completed your profile and interviewed with us, you’ll be exposed to thousands of companies from around the country within the All’s Well network. Benefit from the trust and relationships we’ve generated from over 50 years of doing business with All’s Well and its parent companies.

Join Our Team
All's Well represents excellence in healthcare solutions. Our clients put their trust in us, knowing that our main goal is to satisfy their need for efficient, high-quality staffing. Because of that, we make sure that our corporate staff is benchmarked against an extensive list of attributes, skills and professional experience prior to becoming a member of our team.

As a recognized healthcare consulting and staffing firm, we need people to step in quickly and hit the ground running. We look for candidates whose qualities include interpersonal skills, a strong work ethic, team-oriented attitude and can rise to leadership positions. A proven track record in sales and staffing is also recommended. A history of employment in the healthcare industry is a plus.

If you are driven by personal growth and a strong income, we can provide you with an exciting and rewarding career.Company DescriptionFinding the career that fits you best can feel like putting together pieces of a puzzle. You’re not always sure what’s the right choice to make, and might want some guidance along the way. What you need is an expert who’s seen it all before, someone who has the best insight, and can lend you a few tips along the way. That’s where your dedicated All’s Well Hiring Advisor comes into the picture.\r
\r
\r
We don’t just introduce you to a job opportunity, we present you with a selection of tailored careers among the thousands of employers within our network.\r
\r
\r
Healthcare Staffing Made HumanTM\r
\r
\r
The hiring advisors at All’s Well know just how difficult it can be to find a fitting career. And it is made worse when you aren’t getting the communication you deserve. We have a great deal of respect for your time, and know that the best way to honor it is by giving you results and feedback directly.\r
\r
\r
You are More Than Just a Resume\r
\r
\r
A single piece of paper can’t possibly communicate how unique and amazing you are. We take the time to find out what really makes you tick, and do everything we can to understand all the things that make you the right fit for an employer.\r
\r
\r
We Will Market You\r
\r
\r
We will act as a PR firm that is dedicated just to you. Our personal interviews and assessments are designed to create as many talking points into your profile as possible, making you all that more attractive to our client companies.\r
\r
\r
Our Network is Your Network\r
\r
\r
After you’ve completed your profile and interviewed with us, you’ll be exposed to thousands of companies from around the country within the All’s Well network. Benefit from the trust and relationships we’ve generated from over 50 years of doing business with All’s Well and its parent companies.\r
\r
Join Our Team\r
All's Well represents excellence in healthcare solutions. Our clients put their trust in us, knowing that our main goal is to satisfy their need for efficient, high-quality staffing. Because of that, we make sure that our corporate staff is benchmarked against an extensive list of attributes, skills and professional experience prior to becoming a member of our team.\r
\r
\r
As a recognized healthcare consulting and staffing firm, we need people to step in quickly and hit the ground running. We look for candidates whose qualities include interpersonal skills, a strong work ethic, team-oriented attitude and can rise to leadership positions. A proven track record in sales and staffing is also recommended. A history of employment in the healthcare industry is a plus.\r
\r
\r
If you are driven by personal growth and a strong income, we can provide you with an exciting and rewarding career.

---