Remote RN Care Manager – Appeals & Denials (Per Diem)

Providence; Torrance (CA); Remote; USD 92,000 - 129,000; Part time

Job summary

Providence California Regional Services is seeking a Care Manager Appeals RN for a remote per diem role. The position supports day shifts and focuses on managing and communicating clinically-based appeals with outside payers to ensure reimbursement for services to patients in PH&S ministries.

The CMRA role emphasizes advocacy, patient-centered communication, and adherence to regulatory standards. Required RN license in California, associate degree, and several years of acute-care and

Qualifications

• Must hold California RN license at hire.
• 4 years direct patient care experience in an acute hospital setting.
• 4 years experience as a case manager in an acute hospital setting.

Responsibilities

• Manage and communicate clinically-based appeals between Providence Health and Services, California Region and outside payers.
• Support reimbursement advocacy for services provided to patients served within the PH&S ministries.

Skills

Acute care nursing

Case management

Communication

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 Appeals RN for a remote per diem role. The position supports day shifts and focuses on managing and communicating clinically-based appeals with outside payers to ensure reimbursement for services to patients in PH&S ministries.

The CMRA role emphasizes advocacy, patient-centered communication, and adherence to regulatory standards. Required RN license in California, associate degree, and several years of acute-care and