Appeal Nurse Associate

• Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities
• Supports Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work
• Responsible for the review and resolution of clinical complaints/grievances and appeals
• Interprets data obtained from clinical records to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and provider issues
• Independently coordinates the clinical resolution with internal/external clinician support as required

• 2+ years of clinical experience
• LPN/LVN with current unrestricted state licensure in the state of West Virginia
• Must reside in the state of West Virginia

Managed Care experience preferred

• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
• Paid time off
• Flexible work schedules
• Family leave
• Dependent care resources
• Colleague assistance programs
• Tuition assistance
• Retiree medical access