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RN Nurse - Clinical Appeals Coordinator

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Appeals & Grievances
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230327 Requisition #
Thanks for your interest in the RN Nurse - Clinical Appeals Coordinator position. Unfortunately this position has been closed but you can search our 103 open jobs by clicking here.

Education

Bachelor of Science in Nursing Preferred

Active Unrestricted PA RN License Required

 

Experience, Knowledge, & Skills

                    Minimum Five years clinical experience or equivalent (Intensive Care, Trauma, Home Health a plus)

                    Medical management precertification/retrospective review experience required

                    Oriented in current trends of medical practice

                    Strong problem solving abilities, excellent organizational and planning skills

                    Ability to work independently and provide positive resolution of complex medical and interpersonal challenges

                    Highly professional interpersonal skills for internal and external contacts, particularly in situations where determinations are in conflict with treating providers proposed treatment plans.

 



Hybrid of Choice:

Independence has implemented a “Hybrid of Choice” model which provides our associates with the flexibility to choose whether to work remotely, work in the office every day, or work in the office on certain days at their discretion. However, management may require our associates to work from Independence’s physical office locations on certain occasions. This role is designated as a role that fits into the “Hybrid of Choice” model. While associates may work remotely, the work must be performed in the Tri-State Area of Delaware, New Jersey or Pennsylvania.

Diversity, Equity, and Inclusion

At Independence, everyone can feel valued, supported, and comfortable to be themselves.  Our commitment to equity means that all associates have a fair opportunity to achieve their full potential.  We put these principles into action every day by acting with integrity and respect.  We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace.  Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

About Our Company

Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day.

 

At Independence, we see each of our members as an individual, with unique needs and concerns. We’re dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations.  For more information about Independence access our website at www.ibx.com. We’re revolutionizing health care, and our focus is on you!


Equal Employment Opportunity

Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability. 

Agency Disclaimer

All resumes submitted directly to an Independence Blue Cross employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of Independence Blue Cross and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by Independence Blue Cross or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process. 

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