This is a fully remote position, open to applicants in California.

📋 Description

• Oversee the management and communication of clinically-driven appeals between Providence Health and Services, California Region, and external payers.

• Ensure that activities are centered on patient care, consistent, and adhere to compliance standards.

• Advocate for the reimbursement of services rendered to patients within the ministries of Providence Health and Services.

⛳️ Requirements

• Associate's Degree in Nursing.

• California Registered Nurse License required upon hire.

• Four years of direct patient care experience in an acute hospital environment.

• Four years of experience as a case manager in an acute hospital context.

• Preferred: Bachelor's Degree in Nursing or a Master's Degree in Nursing.

• Preferred: Case management certification required upon hire.

• Preferred: Experience handling denials and appeals in an acute care setting.

• Preferred: Experience within a multi-hospital or integrated healthcare system.

🏝️ Benefits

• Retirement 401(k) Savings Plan with employer matching.

• Comprehensive health care benefits (medical, dental, vision).

• Life insurance coverage.

• Disability insurance.

• Paid parental leave.

• Vacation time.

• Paid holidays.

• Sick leave for health-related issues.

• Optional voluntary benefits.

• Access to well-being resources.

• Additional compensation may be available for shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.