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Appeals RN, Care Management, Per Diem
ProvidenceAppeals RN managing clinically based hospital-care appeals for Providence, a California healthcare network. Advocating for compliant reimbursement and coordinating communications with outside payers.
Posted 8/14/2026part-timeRemote • California • 🇺🇸 United StatesMid-LevelSenior💰 $57 - $89 per hourWebsite
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing clinically-based appeals and advocating for patient reimbursement within an acute care setting. Possesses strong case management skills and a commitment to compliance and patient-focused care.
Highest-signal resume keywords
California Registered Nurse LicenseCase Management CertificationDirect Patient Care ExperienceAcute Hospital Setting ExperienceExperience with Denials and Appeals
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Case ManagementPatient AdvocacyClinical Appeals ManagementReimbursement ProcessesCompliance Standards
Soft Skills
CommunicationCollaborationPatient-Focused Approach
Certifications & Qualifications
California Registered Nurse LicenseCase Management Certification
Industry Keywords
Acute Care SettingIntegrated Healthcare SystemMulti-Hospital ExperiencePatient Care
About the role
Key responsibilities & impact- Manage and communicate clinically-based appeals between Providence Health and Services, California Region and outside payers
- Ensure appeals activities are patient-focused, uniform, and compliant
- Advocate for reimbursement of services provided to patients served within PH&S ministries
- Support overall Care Management Recovery Advocate (CMRA) activities
- Work per diem, 8-hour day shifts
Requirements
What you’ll need- Associate's Degree in Nursing
- Upon hire: California Registered Nurse License
- 4 years direct patient care experience in an acute hospital setting
- 4 years experience as a case manager in an acute hospital setting
- Preferred: Bachelor’s Degree in Nursing or Master's Degree in Nursing
- Preferred upon hire: Case management certification
- Preferred experience working with denials and appeals in/for an acute care setting
- Preferred experience in a multi-hospital and/or integrated healthcare system
Benefits
Comp & perks- Retirement 401(k) Savings Plan with employer matching
- Health care benefits (medical, dental, vision)
- Life insurance
- Disability insurance
- Paid parental leave
- Vacation time
- Holidays/time off benefits
- Voluntary benefits
- Well-being resources
- Additional compensation may be available, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities