Centene Corp. is seeking a Grievance & Appeals Nurse to facilitate medical necessity grievances, appeals and denials while ensuring compliance with NCQA guidelines. This remote role requires California RN/LPN/LVN licensure and PST hours.
You will review clinical data, determine eligibility of claims, and prepare investigations for the Medical Director. The position emphasizes collaboration with providers and members, maintaining timely communications, and contributing to quality improvement
#J-18808-LjbffrRemote Grievance & Appeals Nurse - CA RN in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.