Clinical Nurse Specialist
Remote USARemote (US)mid$90K – $114K
Posted today · via Workday
About this role
Job Description A bit about this role: Under the guidance of the Manager, Clinical Services and Escalations the Clinical Nurse Specialist will function in a very cross functional, diverse capacity working with multiple areas to include as example: UM Operations, Claims, Appeals, Grievances, Quality, Provider Disputes, Payment Integrity, Policy Improvement, Compliance, and other clinical and operational stakeholders. The CNS serves as a clinical subject matter expert for complex cases requiring advanced clinical judgment, interpretation of medical necessity criteria, Medicare Advantage requirements, benefit and coverage considerations, and coordination across multiple areas of the organization.…
What we'd score you on
reqspace match rubricFive dimensions, recruiter-grade. Upload your resume and we'll generate a written explanation of where you fit and where the gaps are.
1
Skills match
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2
Level fit
This role is mid-level. We check your trajectory against it.
3
Domain experience
Your work in the role's domain matters more than your years total. We weight recent and direct experience.
4
Recency
A skill you used last quarter weighs more than one from five years ago. We grade on recency, not lifetime.
5
Location fit
This role is remote-eligible. We factor in your stated location and time-zone overlap.
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