Appeals Nurse Consultant

Job not on LinkedIn

🔥 0 minutes ago

🦌 Connecticut – Remote

🦌 Connecticut – Remote

💵 $66.6k - $142.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💼 Consultant

👻 Ghost score 20%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Lifelancer

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2020

💼 Consulting

🏥 Healthcare

📦 Logistics

💰 Pre Seed Round on 2022-03

Consulting • Healthcare • Logistics

Lifelancer is an AI-powered talent hiring platform that connects employers with skilled professionals in the Life Sciences, Pharmaceutical, and IT sectors. It enables individuals to create profiles showcasing their skills, get matched with high-paying international jobs or projects, and facilitates hiring and payroll for employers in multiple countries. The platform aims to streamline the hiring process with efficient AI sourcing and compliance support.

📋 Description

• Review and resolve clinical appeals • Review documentation and interpret data from clinical records • Apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements • Address member and provider issues • Independently coordinate clinical resolution with internal and external clinician support as required • Support UM, including expedited appeals, MPO, Coding, or Behavioral Health appeals • Work standard Monday–Friday hours, 8:00 AM to 5:00 PM local time

🎯 Requirements

• Active and unrestricted RN licensure in state of residence • 3+ years clinical experience • Associate's Degree minimum • Appeals, Managed Care, or Utilization Review experience preferred • Proficiency with computer skills including navigating multiple systems • Exceptional communication skills • Time efficient, highly organized, and able to multitask • Dedicated workspace free of interruptions • Separate care arrangements for dependents during work hours • Availability for occasional weekend and holiday on-call coverage may be required

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program in addition to base pay • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being, based on eligibility