About this role
Grievance & Appeals Nurse Specialist at CalOptima Health. Location: Orange or California. Role: managing appeals, preparing reviews, attending hearings Requirements: High school diploma plus 5 years healthcare/managed care experience required; current unrestricted CA RN or LVN license preferred; strong clinical review, communication, and regulatory knowledge. Category: Healthcare Services - Nursing Seniority: Senior Level Tools: Microsoft Word, Microsoft Outlook, Microsoft Excel, Microsoft PowerPoint Certifications: rn, lvn Commitment: Full Time Workplace: Remote Languages: English