The posting
Key Responsibilities:
- Lead and manage a team of USRNs involved in clinical functions such as utilization management, case management, prior authorizations, appeals, or claims review. - Track and evaluate team performance against established KPIs and SLAs, ensuring quality, productivity, and timely delivery. - Ensure full compliance with HIPAA, client-specific policies, and clinical standards. - Conduct audits and reviews of clinical decisions to maintain accuracy and adherence to protocols.
Qualifications:
- Must hold an active USRN license (from any U.S. state) - Minimum of 1 year experience in an ER and/or ICU setting - Previous leadership or supervisory experience in either a clinical or BPO environment



