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Assistant/Associate Teaching Professor and Program Director, Master of Science in Health Information
University of Massachusetts Lowell
Lowell, Massachusetts
Indiana University School of Public Health: Bloomington
Bloomington, Indiana
University of Arkansas
Fayetteville, Arkansas
Penn State Health - Physician Recruitment
Hershey, Pennsylvania
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The Permanente Medical Group, Inc. (Kaiser Permanente Northern California)
Roseville, California
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Lehigh Valley Health Network
East Stroudsburg, Pennsylvania
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Vanderbilt Health
Nashville, Tennessee
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Penn State Health - Physician Recruitment
Reading, Pennsylvania
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Appeals & Grievances Nurse
DescriptionAs the Appeals & Grievances Nurse, you will play a key role in managing and resolving New Century Health Plan member appeals and grievances. You will:
Ensuring timely, accurate, and thorough review of member and provider complaints, working closely with clinical and administrative teams.Assessing cases to determine the appropriateness of medical care and services rendered in relation to Medicare guidelines, compliance requirements, and internal policies.Identifying and investigating Potential Quality Issues (PQIs) to ensure continuous improvement in care delivery.Complete other duties as assigned. Salary Range: $61.79-$79.91/hourly
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