or apply directly on NeueHealth's site. We never take the application ourselves.
Is this posting real?
- This role has been open
- 22 days NeueHealth's roles stay open a median of 28 days
- Reposted
- No
- Salary listed
- No 42% of NeueHealth's roles list one
- Ghost-job risk at NeueHealth
- moderate 3 stale, 0 reposted of 12 open
- Hiring momentum
- 19 roles opened in the last 90 days ↑ up vs. the prior 90 days
- Last confirmed on the employer's board
- 2026-09-17
Measured from postings appearing on and disappearing from NeueHealth's own greenhouse board since 2026-08-03. Full hiring picture for NeueHealth.
About this role
The Claims Review Nurse at NeueHealth is responsible for ensuring that members receive appropriate benefit coverage for services requiring prior authorization. This role involves reviewing prior authorizations, collaborating with Medical Directors and clinical teams, and communicating authorization decisions to healthcare providers and patients. The nurse will also analyze utilization data, document activities, and participate in quality improvement initiatives.
- benefits
- 1/5
- freshness
- 4/5
- career value
- 4/5
- role clarity
- 4/5
- pay transparency
- 0/5
Scored from the posting itself — how clearly the role is described, how much it says about pay and benefits, and how recently it was listed. Not a judgement of NeueHealth as an employer.
What you need
- Active California license as a (LVN) or Registered Nurse (RN)
- Minimum 2 years of claims review nursing experience in utilization management, case management, or prior authorizations
- Familiarity with insurance authorization processes, medical billing, and coding (e.g., ICD-10, CPT codes)
- Working knowledge of MCG and CMS guidelines
- Strong analytical and critical thinking skills to assess medical necessity
- Proficient in medical terminology and pharmacology
Nice to have
- Certification Managed Care Nursing (CMCN) preferred
Worth weighing
- Remote position may require strong self-motivation and adaptability to change
- No specific salary or benefits mentioned in the posting
- Role involves significant communication with various stakeholders, which may be challenging for some
- Experience with specific platforms (EZ CAP) may be necessary for success
Summarised from NeueHealth's posting. Read the full original.
Listed by NeueHealth on their greenhouse job board, last confirmed open on 2026-09-17. PitchMeAI is not the employer.
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