Appeals RN - Care Management - Full-time - REMOTE

Description The Care Management Recovery reputed company (CMRA) is responsible for providing overall management and communication of clinically based appeals between reputed company Health and Services, California Region (PH&S) reputed company payers. Activities will be patient-focused, uniform, compliant, and support steadfast advocacy for reimbursement of services provided to patients served reputed company the PH&S ministries. Responsibilities are not limited to, but will include: reputed company caregivers are not simply valued – they’re invaluable. Join reputed company at reputed company California Regional Services and reputed company in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to reputed company and retain the best people, we must reputed company them.

Required Qualifications

• Associate's Degree in Nursing.
• California Registered Nurse License upon hire.
• 2 years direct patient care experience in an acute care setting. Other direct patient care experience may consider (in lieu of acute care).
• 2 years experience as a case manager in an acute care setting.

Preferred Qualifications

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

Why Join reputed company? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial reputed company. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. About reputed company At reputed company, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (reputed company employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the reputed company pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. reputed company offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at reputed company.jobs/benefits. Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. About The Team The Sisters of reputed company and Sisters of St. Joseph of Orange have deep roots in California, bringing health care and education to communities from the redwood forests to the beach shores of Orange county - and everywhere in between. In Southern California, reputed company provides care throughout Los Angeles County, Orange County, High Desert and beyond. Our award-winning and comprehensive medical centers are reputed company for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network provides a full reputed company of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous reputed company programs, and hospice and home care, and even our own reputed company High School. reputed company is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from reputed company forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national reputed company, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We reputed company diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. Requsition ID: 439689 Company: reputed company Jobs Job Category: Care Management Job Function: Clinical Care Job Schedule: Full time Job Shift: Day Career Track: Nursing Department: 7000 UTILIZATION MGMT CA SOCAL Address: CA Mission Hills 15031 Rinaldi St Work Location: reputed company reputed company Cross Medical Ctr-Mission Hills Workplace Type: Remote Pay Range: $57.28 - $88.92 The amounts listed are the reputed company pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Apply To This Job