Supervisor Clinical Management

Supervisor Of Clinical Management

We're looking to add a Supervisor of Clinical Management to the BlueCare Utilization Management team. In this leadership role, you'll oversee a dedicated group of nurses who conduct utilization management reviews to assess medical necessity. You'll serve as both a clinical and procedural expertsupporting your team and, when needed, advising medical directors.

Key responsibilities include :

• Supervising daily operations of the clinical review team
• Ensuring compliance with CMS and URAC regulatory requirements
• Developing and refining processes for improved efficiency and clarity
• Providing clinical guidance and support to staff and stakeholders
• Working with vendors in providing oversight and guidance on performance in keeping with BCP TN

This position requires occasional work outside of normal working hours and participation in a rotating on-call schedule.

If you're passionate about clinical excellence and team leadership, we'd love to hear from you!

Job responsibilities include :

Job qualifications : Experience :

Skills / Certifications :

License :

Number of openings available : 1

Worker type : Employee

Company : VSHP Volunteer State Health Plan, Inc

BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.

Further information regarding BCBST's EEO Policies / Notices may be found by reviewing the following page :

BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR / Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.