RN Manager: Appeals & Denials - Onsite Miami Beach

International Executive Service Corps; Miami Beach (FL); On-site; USD 90,000 - 130,000; Full time

Benefits offered by this job

Health benefits

Life insurance

Long-term disability coverage

Healthcare spending accounts

Retirement plan

Paid time off

Pet Insurance

Tuition reimbursement

Employee assistance program

Wellness program

On-site housing for selected positions

Job summary

A healthcare facility in Miami Beach is seeking an Appeals and Denials Nurse Manager to oversee management of payor processes and ensure compliance with clinical denial management. The role requires a Bachelor's Degree and five years of management experience. The position includes developing relationships with payors, managing observation cases, and generating departmental reports. Comprehensive benefits package offered, emphasizing employee well-being, including health benefits, life insurance, and a retirement plan.

Qualifications

• 5 years management or related experience

Responsibilities

• Develops and maintains effective relationships with payors.
• Oversees the management of observation cases.
• Supports the clinical denial management process.
• Ensures concurrent flow of information between departments.
• Participates with entities involved in denial management.
• Generates and interprets reports for compliance.
• Collaborates to generate outcome data.
• Ensures management of data collection across clinical performance.
• Participates in hiring and staff development activities.
• Supports Director in department operational budget.

Education

Bachelor's Degree

Job description

A healthcare facility in Miami Beach is seeking an Appeals and Denials Nurse Manager to oversee management of payor processes and ensure compliance with clinical denial management. The role requires a Bachelor's Degree and five years of management experience. The position includes developing relationships with payors, managing observation cases, and generating departmental reports. Comprehensive benefits package offered, emphasizing employee well-being, including health benefits, life insurance, and a retirement plan.