Clinical Quality Review Lead for Regulatory Audits

Medica; Minnetonka (MN); On-site; USD 78,700 - 118,020; Full time

Benefits offered by this job

401K contributions

Paid volunteer time off

Comprehensive medical benefits

Job summary

A nonprofit health plan is looking for a Supervisor of Quality Reviewers to oversee clinical reviews and regulatory audit operations. The ideal candidate will have a Bachelor's degree, significant clinical healthcare experience, and leadership skills. This role includes direct supervision of the quality review team and requires expertise in regulatory compliance. The position offers a full salary range of $78,700 – $134,900, subject to experience and qualifications, and includes a comprehensive benefits package.

Qualifications

• 5 years of relevant clinical healthcare experience.
• Active Registered Nurse (RN) License preferred.
• Experience in managed care organizations.

Responsibilities

• Lead clinical review and medical record operations.
• Supervise, coach, and manage workload for the team.
• Ensure compliance with audit standards and timelines.

Skills

Leadership

Clinical Review

Regulatory Knowledge

Project Management

Education

Bachelor’s degree (Nursing preferred)

Tools

Microsoft 365

Adobe Acrobat

Job description

A nonprofit health plan is looking for a Supervisor of Quality Reviewers to oversee clinical reviews and regulatory audit operations. The ideal candidate will have a Bachelor's degree, significant clinical healthcare experience, and leadership skills. This role includes direct supervision of the quality review team and requires expertise in regulatory compliance. The position offers a full salary range of $78,700 – $134,900, subject to experience and qualifications, and includes a comprehensive benefits package.