Nurse Claims Advisor, NE
R2025-812
Job Description
Make a Difference at NRECA and Join Us as a Nurse Claims Advisor in Lincoln, NE. Are you passionate about helping others and making a meaningful impact? Join a team that’s proud to be named one of Lincoln’s Best Places to Work! At NRECA, we’re looking for a compassionate and detail-oriented Nurse Claims Advisor who thrives in a mission-driven environment and is ready to grow their career while supporting our members. About NRECA NRECA is a unique national trade association providing advocacy, financial services, and business support services to over 900 consumer owned electric cooperatives across the country. NRECA employees are united by our mission, inclusive culture, collaborative workplace, and commitment to service excellence. As a “best place to work” employer, we operate with integrity, transparency, and a spirit of innovation. About the Insurance & Financial Services Team Join a dynamic and inclusive team that administers industry-leading employee benefit plans. Our work is diverse, intellectually engaging, and deeply impactful. We foster a culture of belonging, driven by values like communication, creative problem-solving, and accountability. If you’re motivated by purpose, enjoy variety, and care about people and outcomes, this is the team for you. If you’re motivated by purpose, enjoy variety, and care about people and outcomes, this is the team for you. What You’ll Do
- Serve as a medical resource for the Group Benefit Department, Product Development & Management (PDM), and NRECA members.
- Coordinate and oversee medical peer review processes.
- Maintain and update nurse-related policy and procedure documentation.
- Provide exceptional customer service to members, plan participants, and providers regarding utilization and case management, prescription drug plans, and emerging treatments.
- Review complex medical reports and claims for eligibility and medical necessity.
What You’ll Gain
- Competitive compensation and outstanding benefits.
- Medical, dental, and vision insurance.
- Matching 401(k) and pension plan.
- Wellness programs and professional development opportunities.
- A supportive team and a culture that values your contributions.
Qualifications
What’s Required of You
- Bachelor of Science in Nursing (BSN) with a current RN license, or an accredited Nursing Diploma/Associate Degree with 10 years of clinical/case management experience.
- Minimum of 5 years in nursing or medical case management.
- Strong medical/surgical background preferred.
- Case Management Certification preferred.
- Excellent collaboration, communication, and multitasking skills.
Work Schedule Location: Hybrid (Lincoln, NE) Schedule: Monday–Friday, 8:15 a.m. – 5:00 p.m., 3-days in-office, 2-days at home. Ready to take the next step in your NRECA journey? Apply today and help us continue delivering excellence to our members! Additional Requirement: The preceding job description has been written to reflect management’s assignment of essential functions. It does not prescribe or restrict the tasks that may be assigned. All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. NRECA is committed to working with and providing reasonable accommodation to individuals with physical and mental disabilities. If you need special assistance or an accommodation while seeking employment, please e-mail [email protected] or call: 703-907-5992 - NRECA Arlington Human Resources. Please call 402-483-9275 - NRECA Lincoln Human Resources, for Lincoln, NE employment opportunities. We will make a determination on your request for reasonable accommodation on a case-by-case basis. The U.S. Equal Employment Opportunity Commission (EEOC) recently released the 'Know Your Rights' poster, which updates and replaces the previous "EEO is the Law" poster and "EEO Is the Law Poster Supplement". Pay Transparency Non-Discrimination. NRECA will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay. Please see the Pay Transparency Nondiscrimination Provision for more information. E-Verify. As a Federal Contractor, NRECA is required to participate in the E-Verify Program to confirm eligibility to work in the United States. For information please click on the following link: E-Verify. For more information about life at NRECA please visit www.Electric.coop. Apply tot his job Apply To this Job