Remote RN Grievance & Appeals Specialist

Phaxis is seeking an experienced registered nurse to investigate and manage clinical grievances, appeals, and external reviews from intake to resolution. The role emphasizes reviewing medical necessity, quality-of-care concerns, and coordination across settings from outpatient to long-term care, all within regulatory deadlines. You will collaborate with Medical Directors, draft determination letters, and coordinate external reviews including NYS Fair Hearings, CMS IRE, and QIO reviews, while