Appeals and Grievances Nurse Specialist RN II

The Appeals and Grievances Nurse Specialist RN II provides direct assistance to members with health care access or benefit coordination issues, ensuring that clinical grievances, complaints and complex issues are investigated and resolved to the member's satisfaction in a manner consistent with L.A. Care, Centers of Medicare and Medicaid Services (CMS) and regulatory guidelines.

Requirements

• Associate's Degree in Nursing
• At least 5 years of experience in Clinical RN
• At least 2 years in Medicare/ Medicaid in a managed care/ health plan environment

Benefits

• Paid Time Off (PTO)
• Tuition Reimbursement
• Retirement Plans
• Medical, Dental and Vision
• Wellness Program
• Volunteer Time Off (VTO)