Remote Clinical Appeals Nurse: UM & Grievances Expert
Brighton Health Plan Solutions
Brighton Health Plan Solutions is seeking a Clinical Appeal and Grievance Nurse to conduct clinical and benefit reviews in a production-driven environment. The role requires an active RN or LPN license and at least 5 years of experience in Clinical Appeals within managed care. Key responsibilities include analyzing medical necessity appeals, preparing cases for review, and ensuring compliance with regulatory requirements. This position is remote and emphasizes independence and accountability in a fast-paced setting. #J-18808-Ljbffr
Vacancy posted 10 hours ago
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