[Hiring] Appeals RN - Case Management @Providence

Role Description

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.

Qualifications

• 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.

Requirements

• Bachelor's Degree Nursing or Master's Degree Nursing (preferred).
• Case management certification upon hire (preferred).
• Experience working with denials and appeals in/for an acute care setting (preferred).
• Experience in a multi-hospital and/or integrated healthcare system (preferred).

Benefits

• Best-in-class benefits designed to support you and your family in staying well, growing professionally, and achieving financial security.
• Comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching.
• Health care benefits (medical, dental, vision).
• Life insurance and disability insurance.
• Time off benefits (paid parental leave, vacations, holidays, health issues).
• Voluntary benefits and well-being resources.