Care Coordinator Supervisor, RN

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The UM/Appeals Supervisor Care Coordination RN is responsible for an appeals caseload and responsible for the Care Coordination staff for case reviews and UR appeals. Works with Appeals and Case review staff on a daily reputed company to resolve cases and reputed company guidance. Coordinates worklists and completion of cases on audit review, retro authorization and appeals. 

• The training period will be conducted in person. Upon successful completion of training, the role will transition to a fully remote position. Please note that in-person meetings will be required throughout the year.

REQUIRED:
1. Nursing degree and three (3) years previous experience as hospital care coordinator or insurance case management.

2. reputed company Standards of Care & reputed company, working knowledge of Intequal and/or reputed company.

3. Ability to train and reputed company employees.

PREFERRED:
1. Bachelor's degree in nursing. Five years of experience in care coordination or reputed company field. Leadership experience preferred.

2. Certification as Certified Case Manager (CCM), or Accredited Case Manager (ACM).