Associate degree in nursing or accredited school of nursing; 2 years clinical plus 1 year utilization/medical review, or 3 years clinical; active unrestricted RN license; CMS residency requirement (3 of last 5 years in US); word processing and managed care knowledge.

Key Responsibilities

• researching appeals
• performing clinical reviews
• documenting decisions

Skills & Tools

word processing software

Job Details

• Category: Healthcare Services - Nursing
• Seniority: Mid Level
• Commitment: Full Time
• Workplace: Remote — South Carolina or Georgia or Vermont or Hawaii or Utah or Texas or Washington or Idaho or Virginia or West Virginia or Wyoming or Wisconsin or Alaska or Illinois or Arkansas or California or Colorado or Connecticut or Delaware or District of Columbia or Kentucky or Maine or Maryland or Indiana or Minnesota or Michigan or Iowa or Massachusetts or Kansas or Mississippi or Missouri or Montana or Nevada or Nebraska or New Jersey or Louisiana or New Hampshire or New Mexico or New York or North Carolina or South Dakota or North Dakota or Ohio or Oklahoma or Oregon or Pennsylvania or Rhode Island or Alabama or Arizona or Florida or Tennessee
• Salary: USD 53,462 – 102,258 / year
• Languages: English

Benefits

• 401k matching
• Generous paid time off
• Tuition reimbursement
• Retirement plan

About BlueCross BlueShield of South Carolina

A health insurance company and administrator of government contracts, part of the BlueCross BlueShield family. — Industry: Healthcare