Registered Nurse Medical Review Supervisor
Job Summary
Overseeing all medical review activities for the Managed Care Project, the full-time remote Registered Nurse Medical Review Supervisor will manage department compliance, assess review quality, and coordinate workflow to ensure timely actions are completed while supporting healthcare integrity initiatives.
Key responsibilities
- Develop and implement Medical Review policies and ensure departmental compliance
- Monitor quality of reviews and productivity to meet management expectations
- Manage hiring and training of Medical Reviewer staff, ensuring necessary education is provided
Required qualifications
- Active Registered Nurse (RN) license in the state of residence, with preference for a Bachelor of Science Degree in Nursing
- Minimum of three years in a supervisory or management position
- At least four years of clinical experience in a medical/surgical setting preferred
- Experience in medical/utilization review or fraud investigation preferred
- No adverse actions pending or taken against the candidate by any licensing board
Complete Job Description
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