New York Licensed Clinical Supervisor

A company is looking for a Supervisor, Clinical Grievance and Appeals.

Key Responsibilities

Supervise nurses in the clinical Appeals and Grievance department, ensuring compliance with state / federal regulations and NCQA standards

Utilize clinical expertise to assist with escalated or complex clinical issues and monitor team performance

Identify process improvement opportunities and train new team members while managing caseload distribution

Required Qualifications

Bachelor's degree in Nursing preferred

3+ years of nursing experience, including appeals and grievance or utilization management

Previous supervisory experience strongly preferred

LPN required (RN preferred)

Proficient with Microsoft Office applications; knowledge of coding and quality improvement preferred