Clinical Appeals
CareSource
About this role
A Clinical Appeals Nurse is a licensed registered nurse responsible for adjudicating clinical appeals and representing the organization in state hearings to ensure regulatory compliance and alignment with medical policy. The role centers on applying clinical expertise and organizational policy to decisions across care settings and coordinating with clinical leadership. The position requires nursing licensure and experience in managed care or utilization review environments.
Skills
Qualifications
About CareSource
caresource.comCareSource is a nonprofit managed care organization that provides health insurance plans and related healthcare services, primarily through Medicaid, Medicare, and Marketplace offerings. The company works with members, providers, and government partners to deliver access to medical, behavioral health, and care management services in the health insurance industry.
Recent company news
Modern HealthcareDeals tracker: Elsevier to acquire Mytonomy
1 day ago
WPRInsurance provider will stop offering Affordable Care Act coverage in 11 Wisconsin counties
Sep 19, 2025
Hospice NewsCareSource Sees Reduced Hospitalizations Via Tuesday Health Partnership
Oct 14, 2025
Dayton Daily NewsCareSource and other local companies are up for state tax credits
Dec 11, 2025
Captive InternationalAM Best posts A- ratings for CareSource Re
1 month ago
About CareSource
Headquarters
San Francisco, CA
Company Size
201-500 employees
Founded
2018
Industry
Technology
Glassdoor Rating
4.2 / 5
Leadership Team
Sarah Johnson
Chief Executive Officer
Michael Chen
Chief Technology Officer
Emily Williams
VP of Engineering
David Rodriguez
VP of Product
Jessica Thompson
Chief Financial Officer
Andrew Park
VP of Sales
Unlock Company Insights
View leadership team, funding history,
and employee contacts for CareSource.
Salary
$63k – $100k
per year
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