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New Jersey Licensed Appeal Analyst RN

Company: VirtualVocations
Location: Oxnard
Posted on: September 15, 2023

Job Description:

A company is looking for a New Jersey Licensed Appeal Analyst RN.
Key Responsibilities:

Handle all Utilization Management medical appeal cases
Ensure timeliness guidelines are met and appeals are handled in compliance with regulatory requirements
Assess patient's clinical need, evaluate medical services and procedures, and participate in quality improvement program

Required Qualifications:

Active NJ/Compact license
Experience in Utilization Management Appeals
Knowledge of regulatory guidelines including NCQA, NJ State, and CMS
Ability to review medical records and document accurately
Strong problem-solving and analytical skills

Keywords: VirtualVocations, Oxnard , New Jersey Licensed Appeal Analyst RN, Healthcare , Oxnard, California

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