Remote RN Care Manager: Appeals & Care Coordination

Agence PROvidence; United States; Remote; USD 85,000 - 115,000; Full time

Job summary

Providence California Regional Services is seeking a Care Manager RN for a remote, full-time role with day shifts. The CMRA will coordinate clinically based appeals between PH&S and outside payers, focusing on patient-centered advocacy for reimbursement of services.

Ideal candidates hold an Associate Degree in Nursing, CA RN license, and at least 4 years of direct patient care and case management experience in acute care settings. Preferred may include higher nursing degrees and certification.

Qualifications

• Associate's Degree in Nursing required.
• California RN license required upon hire.
• Minimum of 4 years direct patient care in an acute hospital setting.
• Minimum of 4 years as a case manager in an acute hospital setting.

Responsibilities

• Provide overall management and communication of clinically based appeals between Providence Health and Services and external payers.
• Support reimbursement advocacy for services provided to patients served within PH&S, California Region.
• Maintain patient-focused, compliant processes and professional communication across teams.

Skills

Direct patient care

Case management

Communication skills

Nursing license

Education

Associate's Degree in Nursing

Bachelor's Degree in Nursing

Master's Degree in Nursing

Job description

Providence California Regional Services is seeking a Care Manager RN for a remote, full-time role with day shifts. The CMRA will coordinate clinically based appeals between PH&S and outside payers, focusing on patient-centered advocacy for reimbursement of services.

Ideal candidates hold an Associate Degree in Nursing, CA RN license, and at least 4 years of direct patient care and case management experience in acute care settings. Preferred may include higher nursing degrees and certification.