Registered Nurse Clinical Manager

Job Summary

A company is looking for a Senior Manager Clinical Review.

Key Responsibilities

• Oversee daily operations of the Clinical Review Department, including Utilization Management and Claims Medical Management functions
• Conduct data analysis to identify trends, staffing needs, and risks to enhance departmental effectiveness
• Collaborate with the Associate Director to ensure accountability for assigned staff

Required Qualifications

• Bachelor's Degree
• Active state Registered Nurse license in good standing
• 7 years of experience in direct clinical care or managed care
• 3 years of management experience
• Prior Utilization Management experience