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Appeals RN - Care Management Per Diem Remote at Providence Medical Grp.

Torrance, California, United States -

Full Time

Start Date

Immediate

Expiry Date

28 Feb, 26

Salary

0.0

Posted On

30 Nov, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Nursing, Case Management, Patient Care, Acute Care, Clinical Appeals, Healthcare Advocacy, Communication, Compliance, Reimbursement, Multi-Hospital Systems, Denials Management, Patient-Focused Care, Whole-Person Care, Caring for Vulnerable Populations, Team Collaboration, Crisis Management

Industry

Hospitals and Health Care

Description

Appeals RN - Care Manager Remote. This position is Per Diem and will work 8-hour, Day shifts. 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. Responsibilities are not limited to, but will include: Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence California Regional Services and thrive 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 inspire and retain the best people, we must empower them. Required Qualifications: Associate's Degree Nursing. Upon hire: California Registered Nurse License. 2 years Direct patient care experience in an acute care setting. Other direct patient care experience may considered (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 Nursing. Upon hire: Case management certification. Experience working with denials and appeals in/for an acute care setting. Experience in a multi-hospital and/or integrated healthcare system. Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

Responsibilities

The Appeals RN is responsible for managing and communicating clinically-based appeals between Providence Health and Services and outside payers. Responsibilities include advocating for reimbursement of services provided to patients served within the PH&S ministries.