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

📋 Description

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

• Ensure that activities are patient-centered, standardized, and compliant with regulations.

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

⛳️ Requirements

• Associate's Degree in Nursing.

• California Registered Nurse License required upon hire.

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

• 4 years of experience as a case manager in an acute hospital setting.

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

• Preferred: Case management certification required upon hire.

• Preferred: Experience dealing with denials and appeals in an acute care context.

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

🏝️ Benefits

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

• Health care benefits including medical, dental, and vision coverage.

• Life insurance.

• Disability insurance.

• Paid parental leave.

• Vacation and holiday time off.

• Health-related time off benefits.

• Voluntary benefits.

• Well-being resources.

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