Care Coordinator - Clinical Appeals RN
Compensation
$80k – $126k /yr
Employment type
Full-time
Work setting
On-site
Location
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Schedule
Day shift
Posted
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Job overview
The Care Coordinator - Clinical Appeals RN is an onsite role based in the United States. The annual salary range is $80,200.00 - $125,600.00. This role supports the health plan operations at Premera Blue Cross. This role exists to perform medical necessity reviews for clinical appeals and prior authorizations. The RN will partner with Medical Directors to determine the appropriateness of clinical requests, ensuring cost-effective care and compliance with medical policies and member benefits.
What you'll do
- Perform medical necessity reviews, consult with Medical Directors, document clinical information, and identify clinical program opportunities.
What we're looking for
- Skills & competencies
- full-timeday shiftrncare coordinatorclinical appealsutilization managementhealthcare$80k-$125konsite
- Work arrangement
- Weekend coverage required
Benefits & perks
- Medical/vision/dental, 401k match, pension plan, and tuition assistance.
Why this role
Requires RN licensure, 3+ years of clinical experience, and utilization management experience.
About the employer
Premera Blue Cross is hiring for this role. Industry: Direct Health and Medical Insurance Carriers. Sector: 52.
Additional details
- Industry sector
- 52
- Industry
- Direct Health and Medical Insurance Carriers
- Occupation code
- 29-1141.04
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Listing ID: 6fe13dc2-4624-45ca-94d0-89490e04caa2