RN (California) Nurse Appeals

Job description

Anticipated End Date: 2026-04-30 Position Title: RN (California) Nurse Appeals Job Description: RN Nurse Appeals (California) Location: Must reside in California, Nevada, or Colorado. NOTE : Associates in this job working from a California location are eligible for overtime pay based on California employment law. Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting locations will not be considered for employment, unless an accommodation is granted as required by law. The Nurse Appeals is responsible for investigating and processing grievances from members and providers telephonically and through written correspondence/requests. Primary duties may include, but are not limited to: Conducts investigations and reviews of member and provider grievances. Extrapolates and summarizes medical information for medica...