Appeals & Grievances RN Coordinator
at RCM Health Care Services

Date Posted: 11/8/2018

Job Description

Appeals & Grievances RN Coordinator
Opportunity to telecommute 2 or 3 days per week after 6 months of training in office
Location: Brooklyn, NY
Salary range: $80k - $95k + Bonuses (based on experience + credentials)
 
Medicare and Medicaid managed care health plans expanding services in response to patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.
Responsibilities:
The RN Coordinator will investigate and respond to written and/or verbal clinical appeals, expedited clinical grievances and potential quality of care grievances submitted by members and providers in accordance with Organization Contract Benefits, CMS (Centers for Medicare & Medicaid Services), and DOH (Department of Health) regulations.
Qualifications:
  • Graduate of accredited nursing program; BSN preferred
  • 2 years managed care or hospital based utilization/case management experience
  • 2 years minimum clinical experience
  • Licensed nurse in New York State
  • Proficiency with Microsoft Word, Excel, Power Point and Outlook is required
  • Must have excellent written and verbal communication skills
  • Must be comfortable researching current evidence based practice guidelines and protocols
  • Must be able to multi-task and managed multiple projects efficiently, meet deadlines, demonstrate analytical/critical thinking skills, and provide excellent customer services that leads to positive problem resolution
Our Client offers outstanding benefits including:
  • Employee and family health coverage
  • Competitive salaries
  • Employer contributed pension plan
  • 20 Vacation days
  • 3 personal days
  • 12 sick days
  • 10 holidays
  • Employee tuition reimbursement
  • Dependent tuition reimbursement
  • 403(b) retirement plan
 
 

Job Snapshot

About Us

RCM Health Care Services offers career defining opportunities to candidates from the leading employers in health care. Whether you’re looking for a new job or seeking to hire the best medical talent, RCM Health Care Services has the solution for you. Since 1975, we’ve established ourselves as a leader in the recruitment industry by connecting thousands of healthcare professionals with placements that support their needs. If you’re looking to make the next move in your career, let RCM be your guide, we’re with you every step of the way!

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