State Licensed Clinical Review Manager

Job Summary

Managing a remote team of nurses and audit roles, the full-time State Licensed Clinical Review Manager will oversee clinical review audits, ensure operational efficiency, and support strategic management activities.

Key responsibilities

• Oversee the Complex Clinical Bill Review team, managing production expectations and team performance
• Continuously evaluate processes and perform requirements gathering to address any operational issues
• Develop training materials and coordinate quality assurance processes for the clinical review team

Required qualifications

• Current, unrestricted nursing license in good standing; certified coding certification is a plus
• 3+ years of supervisory or leadership experience in a similar business environment
• 3+ years of experience performing clinical audits of itemized bills
• Proven experience with healthcare industry software products and process development
• Strong project management skills and ability to manage multiple projects in a team environment