RN Clinical Appeals Specialist — Grievances Expert
Healthfirst
Healthfirst is seeking an Appeals & Grievances Clinical Specialist to lead clinical case development and resolution for member and provider appeals, ensuring compliance with federal and state regulations. The role may be remote or on-site at NYC or Lake Mary locations and may require travel for meetings.
The incumbent will manage their own caseload, investigate cases, and prepare submissions for review by Medical Directors and external appeals, while meeting regulatory timeframes and maintaining
#J-18808-LjbffrVacancy posted 1 day ago
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