Grievance and Appeals Nurse Specialist Needed!
Orangeonsitemid
Posted 143mo ago · via Smartrecruiters
About this role
About Healthcare Talent is assisting our client in hiring a Grievance & Appeals Nurse Specialist. The ideal candidate will manage the department work activities to ensure that service standards are met, and operations are consistent with the health plan policies, as well as the policies of the regulatory agencies. The Grievance and Appeals (GARS) Nurse Specialist participates in managing the organization’s State Hearing review for all lines of business, including handling expedited and standard requests and providing oversight of program assistant/resolution specialists assigned to assist in processing of the cases. Ensures State Hearing requests are processed in accordance with regulations, compliance standards and policy and procedures.…
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
We compare your skills against the role requirements.
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 based in Orange. We weight your proximity and willingness to relocate.
Score yourself on this role.
Free · no card · written explanation included
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