Senior RN - Medi-Cal Appeals & Grievances; Hybrid
Listed on 2026-10-11
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Healthcare
Healthcare Administration, Healthcare Management
Blue Shield of California's Medi-Cal Member Appeals and Grievances team reviews member appeals and grievances from preservice to claim denial. The RN Senior will perform timely clinical reviews using Milliman Care Guidelines and NCCN/ACOG standards, ensuring medical necessity, coding accuracy and policy compliance.
This hybrid role requires California RN licensure, a nursing degree (BSN preferred), 5+ years in nursing or healthcare, and independent clinical judgement.
The Senior RN
- Medi-Cal Appeals & Grievances (Hybrid) position in the Bio & Pharmacology & Health, Other field is open for applications.
We invite applications for the Senior RN
- Medi-Cal Appeals & Grievances (Hybrid) position located in Long Beach, CA, United States.
The following opening is for a Senior RN
- Medi-Cal Appeals & Grievances (Hybrid) with Blue Shield of CA.
Our organisation is growing, and we are hiring a Senior RN
- Medi-Cal Appeals & Grievances (Hybrid) in Long Beach, CA, United States.
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