About the role

A healthcare service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and clinical case resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist license. Responsibilities include developing cases, researching issues, and ensuring compliance with regulations. Ideal candidates should have experience in clinical practice and knowledge of Utilization Review Guidelines. The position offers a competitive salary and an opportunity to work with a dynamic team.

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JOB OVERVIEW

Experience level

Senior

Location

New York, NY

Occupation

Clinical Nurse Specialists

Industry

All Other Miscellaneous Ambulatory Health Care Services

Posted

17 days ago

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