About this opportunity
Blue Shield of California lists this Senior RN, Medi-Cal Appeals & Grievances - Hybrid opportunity in rancho cordova, California. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Blue Shield of California seeks an RN Senior to clinically review Medi-Cal member appeals and grievances. You will perform first level reviews using established guidelines and document medical necessity and coding accuracy.
You will coordinate with Medical Directors and staff to address PQI/QOS/QOC cases within the required timeframes. Hybrid virtual work enables some remote days, with in-office visits as needed for business requirements.
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Worksite address
rancho cordova, CA, 95741, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.