Remote RN Care Manager for Appeals & Reimbursement

NEPSE Trading; United States; Remote; USD 90,000 - 120,000; Full time

Job summary

Providence California Regional Services seeks an RN Care Manager for a remote, full-time role. The position supports patient-centered care management and appeals coordination, focusing on reimbursement for services in the PH&S network.

California RN license is required along with substantial direct patient care and case management experience. The role emphasizes compliant, thoughtful communication with payers and across hospital settings to ensure ongoing access and coverage for patients served

Qualifications

• Associate's Degree in Nursing is required
• California RN License must be active at hire
• 4+ years direct patient care in acute hospital setting
• 4+ years as a case manager in acute hospital setting

Responsibilities

• Coordinate and communicate clinically-based appeals between Providence Health and Services, California Region and external payers.
• Advocate for reimbursement of services for patients served within PH&S ministries, ensuring compliance and patient focus.
• Support unified, compliant care management practices across the network.

Skills

Case management

Direct patient care

Communication

Appeals processing

Education

California Registered Nurse License

Associate's Degree in Nursing

Bachelor's Degree in Nursing

Master's Degree in Nursing

Tools

Case management software

Job description

Providence California Regional Services seeks an RN Care Manager for a remote, full-time role. The position supports patient-centered care management and appeals coordination, focusing on reimbursement for services in the PH&S network.

California RN license is required along with substantial direct patient care and case management experience. The role emphasizes compliant, thoughtful communication with payers and across hospital settings to ensure ongoing access and coverage for patients served