RN Licensed Appeals Team Lead

Job Summary

Leading a team of Clinical Validation Auditors, the full-time RN Licensed Appeals Team Lead will supervise audit processes focused on Place of Service, Short Stay, and Readmission appeals, ensuring quality outcomes and adherence to client standards while providing training and performance optimization for team members.

Key responsibilities

• Oversees audit team to ensure quality audit outcomes and adherence to clinical validation guidelines
• Optimizes team performance through training, process improvements, and monitoring of productivity and quality deliverables
• Collaborates with management on employee relations, performance management, and recruitment of top talent

Required qualifications

• Associate or Bachelor's degree in nursing
• Active and unrestricted RN License in the state of residence
• 2+ years of management or supervisory experience preferred
• 5+ years of experience in Auditing, Quality, or Appeals related to Place of Service, Short Stay, and Readmission
• Proficiency in Microsoft Excel, Access, and system databases