New York Licensed Clinical Appeals RN

Job Summary

A company is looking for a Clinical Appeals RN (Medicaid) to work remotely.

Key Responsibilities

• Review and analyze clinical appeals and grievances to determine appropriate care
• Write nursing tools and reference information to support clinical product design
• Address complex issues with minimal guidance and coach others on difficult topics

Required Qualifications

• Active, unrestricted RN licensure in the state of residence
• 3+ years of clinical experience in a hospital, acute care, or direct care setting
• Experience in medical record and appeal review
• Proficient in Microsoft applications and solid PC skills
• Ability to work until 5 PM CST and access to high-speed internet from home