Senior RN, Medicare Appeals & Grievances Lead

A leading health services provider in Oakland, California is seeking a Medicare Appeals RN Senior responsible for reviewing member appeals, grievances, and ensuring compliance with Medicare guidelines. The ideal candidate will hold a Bachelor of Science in Nursing and have a current California RN license with at least 5 years of experience in nursing or healthcare. This role focuses on both medical and pharmacy appeals, requiring strong clinical judgment and knowledge of Medicare policies. #J-18808-Ljbffr