Supervisor (RN)

IPRO; Jericho (NY); Hybrid; USD 92,000 - 100,000; Full time

Job summary

IPRO in Jericho, NY seeks a Clinical Supervisor (RN) to oversee the full spectrum of Federal IDR case determinations, including clinical reviews and physician level assignments. The role manages case staging between external experts, guides appeals, and directs a team of clinical reviewers to ensure timely, accurate final determinations.

The ideal candidate is a licensed RN with a BSN or approved program, 2 years clinical experience, and 1 year in IDR.

Qualifications

• RN license required.
• BSN or approved RN training program.
• Minimum 2 years clinical experience.
• Minimum 1 year in Independent Dispute Resolution.
• Strong communication and organizational skills.
• Ability to lead and train teams.

Responsibilities

• Conduct clinical reviews and chart screening.
• Determine physician level assignment and case staging.
• Oversee appeal processes within strict deadlines.
• Direct clinical reviewers and monitor quality.
• Train and mentor new RNs.
• Manage timesheets, productivity, and attendance.
• Set performance goals and report variances.
• Communicate with customers to resolve issues.

Skills

EMR systems

Team supervision

Communication skills

Independent work

Deadline-driven

Education

RN license

BSN or approved RN program

Tools

EMR software

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Management Jericho, NY, US

6 days ago Requisition ID: 1158

Salary Range: $92,000.00 To $100,000.00 Annually

In the Clinical Supervisor (RN) role, you will complete the full spectrum of activities related to Federal Independent Dispute Review Organization (IDR) case determinations. The Clinical Supervisor (RN) will conduct clinical level review, determine physician level assignment, manage case staging between external physician experts and manage appeal processes within strict deadlines. This individual will direct the workflow of the clinical reviewer's assigned to them, monitor quality control and direct team goals through effective employee training in the final payment determination rationales, and a thorough understanding of single, bundled, and batched cases. The Clinical Supervisor (RN) must be a resourceful team player with a positive attitude and eagerness to ensure customer satisfaction in the Federal IDR Process and for other State and Federal entities. Duties to include but not limited to:

• Conduct reviews which include chart screening, writing case summaries, determining documentation adequacy, researching insurer requirements, complete decision templates and preparing final determinations.
• Training and mentoring new RNs as the project expands.
• Responsible for the day-to-day management of the clinical reviewer's teams assigned to them.
• Responsible for supervisory functions such as employee timelines, employee productivity and reporting measures, reviewing timesheets for final approval, approving time off request, new employee checklist.
• Direct employees and subcontracted staff in meeting quality and on-time delivery requirements.
• Managing workflow and ensuring that employees understand their responsibilities and delegated tasks.
• Set performance goals and deadlines in alignment with the company vision and report variances to senior managers.
• Communicate directly with the customer to troubleshoot concerns, present case scenarios, and communicate new directives and solutions.

This position is office based at our Jericho, NY office.

QUALIFICATIONS:

• Knowledge and experience with electronic medical records.
• Ability to oversee, problem solve, and work collaboratively with peers, medical, analytical, and administrative support staff.
• Excellent written and verbal skills.
• Ability to work independently with little supervision.
• Ability and desire to be flexible, innovative, and creative.
• Ability to meet deadlines in a time sensitive environment.

EDUCATION AND EXPERIENCE:

• Licensed, Registered Nurse, required.
• Baccalaureate degree in Nursing OR graduate of an approved Registered Professional Nurses training program, required.
• T wo (2)years' experience in a clinical setting required.
• One (1) year experience working in Independent Dispute Resolution, required.

The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. The annualized salary range for this position is $92,000.00 - $100,000.00. Actual salary range and /or hourly rate depends on a variety of factors including experience, education, credentials, location, and budget.

The salary range and/or hourly rate listed does not include other forms of compensation or benefits.

IPRO is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or military status, or any other category protected under applicable law.