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Elevance Health
Overview
Investigate and process medical necessity appeals and member grievances, specifically focusing on Quality of Care cases. Prepare clinical summaries for Medical Directors and ensure all resolutions meet regulatory timeframes.
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Compensation
Salary not listed
Posted
3 days ago
The Nurse Appeals Associate supports quality improvement interventions and resolves administrative appeals. They are responsible for tracking grievances, preparing files for Fair Hearings, and conducting internal compliance audits.
4 days ago
Investigate and process medical necessity appeals requests from members and providers. Prepare recommendations for the Medical Director and ensure all grievances are resolved within regulatory timeframes.
$38 - $57 / HOUR
13 days ago
