Description & Requirements
Essential Duties and Responsibilities:
- Provide supervision and clinical oversight to team of direct reports.
- Discuss job performance concerns with direct reports to identify causes and issues and work closely with the HR department on resolving problems.
- Conduct case reviews and consultations as needed; identify need for escalation to management, physician or related disciplines
- Serve as subject matter expert on area of clinical knowledge including training and education
- On contract requiring assessments, may conduct assessments or field training of assessors as needed
- Instruct, demonstrate, observe skills and techniques of nursing staff and provide feedback to management. .
- May attend client and stakeholder meetings
- Performs other related duties as assigned.
Required Skills/Abilities:
- Subject Matter knowledge in area of contract operations
- Ability to identify and prioritize tasks based on level of time sensitivity and/or potential health and safety concerns
- Ensure that all dispute cases are reviewed and processed in a timely and accurate manner.
- Collaborate with healthcare providers, health plans, and other stakeholders to facilitate the resolution of disputes.
- Maintain detailed records of all cases and ensure compliance with HIPAA and other regulatory requirements.
- Monitor and evaluate the performance of staff, providing feedback and coaching as needed.
- Stay informed about current trends and best practices in healthcare billing and dispute resolution.
- Current Registered Nurse (RN) license valid in the state of practice is required-
-Bachelor’s degree preferred, High School Degree or equivalent required
- Minimum of 2 years of nursing experience.
- Prior experience with clinical supervision or as a charge nurse preferred.
Home Office Requirements:
- Internet speed of 20mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via either Wi-Fi or Category 5 or 6 ethernet patch cable to the home router
- Private work area and adequate power source
- Must currently and permanently reside in the Continental US