Nurse Appeals RN-Quality of Care
Elevance Health(1 month ago)
About this role
The Nurse Appeals RN - Quality of Care at Elevance Health is a virtual clinical role focused on handling medical necessity appeals and quality-of-care grievances from members and providers. The position supports medical leadership by summarizing clinical information and ensuring timely, compliant resolution of member and provider concerns.
Required Skills
- Medical Review
- Case Investigation
- Documentation
- Clinical Summaries
- Regulatory Compliance
- Grievance Management
- Communication
- Leadership
Qualifications
- HS Diploma or Equivalent
- RN License (Active, Unrestricted)
- AS Nursing (Preferred)
- BS Nursing (Preferred)
- Multi-State/Compact RN License (Preferred)
About Elevance Health
elevancehealth.comElevance Health, formerly Anthem, Inc., serves people across their entire health journey taking an integrated whole-health approach.
View more jobs at Elevance Health →Apply instantly with AI
Let ApplyBlast auto-apply to jobs like this for you. Save hours on applications and land your dream job faster.
More jobs at Elevance Health
Similar Jobs
CMS Grievance Coordinator – CMS Grievance – Willard Hospital
Health(1 month ago)
Appeals and Grievances Clinical Specialist
France Cars SAS AAA(7 days ago)
Clinical Appeals Analyst
Blue Cross NC(1 month ago)
Appeals and Grievances Clinical Specialist
France Cars SAS AAA(5 days ago)
Appeals and Grievance Specialist
Presbyterian Healthcare Services(1 month ago)
Appeals Specialist
France Cars SAS AAA(2 months ago)