Appeals RN - Care Management Per Diem - REMOTE

This is a remote, per diem position working 8-hour day shifts.

About the role

The Care Management Recovery Advocate (CMRA) is responsible for providing overall management and communication of clinically-based appeals between Providence Health and Services, California Region (PH&S) and outside payers. Activities will be patient-focused, uniform, compliant, and support steadfast advocacy for reimbursement of services provided to patients served within the PH&S ministries.

Responsibilities

• Manage and communicate clinically-based appeals between PH&S and outside payers.
• Advocate for reimbursement of services provided to patients.

Requirements

• Associate's Degree in Nursing.
• California Registered Nurse License (upon hire).
• 4 years of direct patient care experience in an acute hospital setting.
• 4 years of experience as a case manager in an acute hospital setting.

Qualifications

• Bachelor’s Degree in Nursing or Master's Degree in Nursing (preferred).
• Case management certification (upon hire, preferred).
• Experience working with denials and appeals in/for an acute care setting (preferred).
• Experience in a multi-hospital and/or integrated healthcare system (preferred).

Benefits

Providence offers a comprehensive benefits package including:

• Retirement 401(k) Savings Plan with employer matching.
• Health care benefits (medical, dental, vision).
• Life insurance and disability insurance.
• Time off benefits (paid parental leave, vacations, holidays, health issues).
• Voluntary benefits and well-being resources.

Pay

The pay range for this position is $57.28 - $88.92 per hour. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and foster an inclusive workplace where diversity is valued, and everyone is essential, heard, and respected.

Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics, and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas, and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices, and continuing our more than 100-year tradition of serving the poor and vulnerable.