Job Description
Responsibilities
- Lead and manage a team of USRNs involved in clinical functions such as utilization management, case management, prior authorizations, appeals, or claims review.
- Track and evaluate team performance against established KPIs and SLAs, ensuring quality, productivity, and timely delivery.
- Ensure full compliance with HIPAA, client-specific policies, and clinical standards.
- Conduct audits and reviews of clinical decisions to maintain accuracy and adherence to protocols.
Qualifications
- Must hold an active USRN license (from any U.S. state)
- Minimum of 1 year experience in an ER and/or ICU setting
- Previous leadership or supervisory experience in either a clinical or BPO environment
Ready to Apply?
Take the next step in your AI career. Submit your application to HRTX today.
Submit Application