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Registered Nurse Claim Review ManagerVirtualVocations • San Francisco, California, United States
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Registered Nurse Claim Review Manager

Registered Nurse Claim Review Manager

VirtualVocations • San Francisco, California, United States
5 days ago
Job type
  • Full-time
Job description
A company is looking for a Clinical Claim Review Manager, responsible for overseeing a team conducting clinical reviews to enhance provider and member outcomes. Key Responsibilities Manage a team performing clinical claim reviews based on state and federal guidelines Gather and communicate performance metrics to staff, ensuring adherence to company policies Provide training and coaching to direct reports while participating in process improvements and project development Required Qualifications Current unrestricted RN license in the state of residency 3+ years of RN experience, including clinical experience in an inpatient/acute setting Leadership or supervisory experience Proficiency in computer skills, including Microsoft Suite Demonstrated clinical documentation skills and ability to handle a fast-paced environment
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Registered Nurse Claim Review Manager • San Francisco, California, United States

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