RN Clinical Supervisor - Utilization Management Lead

Acentra Health; McLean (VA); Presencial; USD 84 000 - 92 000; Tempo integral

Resumo da oferta

Acentra Health is seeking a Clinical Supervisor (RN) to lead Utilization Management and ensure clinical programs meet high standards while strengthening relationships with customers. The role includes overseeing utilization reviews and acting as a Subject Matter Expert in a collaborative leadership environment.

Required is an active RN license (Indiana or compact), 2+ years in healthcare management, and 5+ years in a lead utilization management role.

Qualificações

• Active, unrestricted Licensed RN in Indiana or compact license.
• Associate degree or equivalent directly applicable experience in nursing, healthcare administration or related area.
• 2+ years of health care management experience.
• 5+ years of experience in a lead position in a quality and utilization management program.

Responsabilidades

• Manage and oversee Utilization Management activities.
• Ensure overall consistency, thoroughness, and accuracy of clinical programs.
• Oversee program to ensure clinical efficiencies, deliverables, and contract functions meet high standards.
• Strengthen relationships with customers and meet contract requirements.
• Provide day-to-day oversight to manage the utilization review program.
• Responsible for utilization reviews as defined by the contract to include prior authorization and retro reviews.
• Serve as a Subject Matter Expert (SME).
• Participate as a team member fostering collaborative decision-making among leadership, committees, teams, or work groups of diverse composition.
• Perform other duties as assigned.
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

Conhecimentos

RN licensure

Healthcare management

Leadership

Formação académica

Associate degree in nursing

Bachelor's degree preferred

Ferramentas

Microsoft Office

Utilization Review systems

Descrição da oferta de emprego

Acentra Health is seeking a Clinical Supervisor (RN) to lead Utilization Management and ensure clinical programs meet high standards while strengthening relationships with customers. The role includes overseeing utilization reviews and acting as a Subject Matter Expert in a collaborative leadership environment.

Required is an active RN license (Indiana or compact), 2+ years in healthcare management, and 5+ years in a lead utilization management role.