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Medicare Appeals RN Lead; Hybrid — CA Licensed Nurse

Job in Redding, Shasta County, California, 96001, USA
Listing for: Blue Shield of CA
Full Time position
Listed on 2026-07-22
Job specializations:
  • Nursing
    RN Nurse
Salary/Wage Range or Industry Benchmark: 110000 - 140000 USD Yearly USD 110000.00 140000.00 YEAR
Job Description & How to Apply Below
Position: Medicare Appeals RN Lead (Hybrid) — CA Licensed Nurse

Blue Shield of California is seeking an RN Lead for the Medicare Appeals and Grievances team. You will lead a nursing team performing first-level appeal reviews using NCD/LCD guidelines and recognized medical sources.

Responsibilities include ensuring medical necessity reviews and coding accuracy, plus quality audits and process reviews. Ideal candidates hold a CA RN license, a BSN or higher, and have 7+ years of relevant experience with supervisory exposure.

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