Clinical Claim Review Manager - Sioux Falls South Dakota

Company: VirtualVocations
Location: Sioux Falls, South Dakota
Posted On: 11/20/2024

A company is looking for a Clinical Claim Review Manager responsible for managing a team that performs clinical reviews post-service.



Key Responsibilities

Manage a team conducting clinical claim reviews, interpreting state and federal mandates and clinical information
Gather and communicate performance metrics to team members and ensure adherence to company policies
Provide training, coaching, and support for staff development goals while coordinating with other managers


Required Qualifications

Current unrestricted RN license in the state of residency
3+ years of RN experience, including clinical experience in an inpatient/acute setting
Leadership or supervisory experience
Proficiency in computer skills, including Microsoft Suite
Quiet, secure designated workspace with high-speed internet access More...

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