Remote RN: Integrated Care Manager for Appeals

Sentara Hospitals; United States; Remote; USD 90,000 - 136,000; Full time

Benefits offered by this job

Medical & Dental Insurance

Vision Insurance

401(k)/Retirement Plan

Paid Time Off

Job summary

Sentara Health Plans is seeking an Integrated Care Manager/Registered Nurse (RN) for both inpatient and outpatient clinical appeals, with remote work available in Virginia. The role supports review of denials, root-cause analysis, and submission of appeals across payer types.

The ideal candidate has 3+ years of nursing experience, RN license (Virginia or Compact), and strong Excel skills. This full-time, remote-in-Virginia position offers competitive pay and comprehensive benefits.

Qualifications

• Nursing experience required (3 years)
• Experience or knowledge in Rev Cycle, UR and Case Management preferred
• Provider appeals experience is a plus
• Strong proficiency in Excel required

Responsibilities

• Manage inpatient and outpatient provider appeals across all payer types, including government and commercial insurance
• Review clinical denials (non-billing related), identify root causes, and perform post-claim analysis to support appeal submissions

Skills

Nursing experience

Rev Cycle

Utilization Review

Case Management

Excel

Education

RN Diploma (Non-degree)

Bachelor's Degree in Nursing

Job description

Sentara Health Plans is seeking an Integrated Care Manager/Registered Nurse (RN) for both inpatient and outpatient clinical appeals, with remote work available in Virginia. The role supports review of denials, root-cause analysis, and submission of appeals across payer types.

The ideal candidate has 3+ years of nursing experience, RN license (Virginia or Compact), and strong Excel skills. This full-time, remote-in-Virginia position offers competitive pay and comprehensive benefits.