RN Clinical Appeals Nurse

Molina
Gersuch, GA
Job Description
Molina Healthcare is seeking a Clinical Appeals Nurse (RN) to ensure clinical decisions are correct and meet compliance standards. This role involves independently re-evaluating medical claims, applying clinical guidelines, and representing Molina in Administrative Law Judge meetings. The role also involves providing training and mentoring to junior staff.

Requirements

  • Graduate from an Accredited School of Nursing
  • Active, unrestricted State Registered Nursing (RN) license in good standing
  • 3-5 years clinical nursing experience
  • 1-3 years Managed Care Experience

Benefits

  • Competitive benefits package
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