Healthfirst is seeking an A&G Clinical Specialist to lead the development and resolution of clinical cases for member and provider appeals, ensuring compliance with applicable laws and internal policies.
The role can be remote or on-site at the NYC or Lake Mary locations, with travel as needed. You will manage your own caseload, perform issue research, interpret guidelines, and prepare cases for internal and external reviews.
#J-18808-LjbffrClinical Appeals & Grievances Expert (RN) in new york at Unknown Company
This position is listed as full time and able to be worked remotely.