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New Jersey Licensed Appeals Analyst RNVirtualVocations • Pueblo, Colorado, United States
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New Jersey Licensed Appeals Analyst RN

New Jersey Licensed Appeals Analyst RN

VirtualVocations • Pueblo, Colorado, United States
4 days ago
Job type
  • Full-time
Job description
A company is looking for an Appeals Resolution Analyst II-RN. Key Responsibilities Assess patients' clinical needs against established guidelines to ensure appropriate care levels Evaluate the necessity and efficiency of medical services and procedures by inpatient facilities Investigate and resolve complicated appeals, coordinating with the legal department as necessary Required Qualifications, Training, and Education High School Diploma/GED required; Bachelor's degree in health care management preferred 2 years of clinical experience required 3 years of experience in the health care delivery system/industry required Registered Nurse License required Working knowledge of principles of utilization management and health care contracts
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New Jersey Licensed Appeals Analyst RN • Pueblo, Colorado, United States

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