RN Manager Grievances & Appeals - Hybrid

Midland-Marvel Recruiters, LLC

Washington DC

Hospital system looking to bring on RN Manager Grievances & Appeals! Sign On Bonus and Relocation!

Ready to make your application Please do read through the description at least once before clicking on Apply.

Oversees and provides direction for Intake, Appeals (Clinical and Claims), Retrospective Review, Emergency Room Review, and Customer Service/Complaints/Grievances for all lines of business.
Responsible for day to day oversight and management of Intake, Clinical Appeals, Claims Appeals, Complaints, Grievances and Intake functions.

Qualifications:

Bachelor's degree in Nursing Required
Experience working in a Managed Care Organization with strong experience in Medicaid
Specific Experience working with Grievances and Appeals (minimum of 3 years)
3-4 years in UM and 5-7 years of clinical experience in a hospital or medical setting
2 years xhyhwjd of nursing leadership as a supervisor or assistant manager
KSAs Proficiency
CCM - Certified Case Manager Active Certified Case Manager (CCM) or CCM certification within 1 Year Required

Remote working/work at home options are available for this role.

Apply

Vacancy posted 9 hours ago

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