Nurse Appeals RN-Quality of Care
Elevance Health(27 days ago)
About this role
The Nurse Appeals RN — Quality of Care at Elevance Health is a licensed registered nurse who supports member and provider appeal processes by evaluating medical necessity and quality-of-care concerns. The role is primarily virtual and focused on ensuring timely, compliant resolution of grievances while collaborating with clinical leadership. It contributes to member experience and regulatory compliance within the managed care environment.
Required Skills
- Medical Review
- Case Investigation
- Medical Records
- Nurse Summaries
- Grievance Management
- Regulatory Compliance
- Documentation
- Clinical Communication
Qualifications
- HS Diploma
- AS in Nursing
- BS in Nursing
- RN License
- Multi-State RN License
About Elevance Health
elevancehealth.comElevance Health, formerly Anthem, Inc., serves people across their entire health journey taking an integrated whole-health approach.
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