Job Description
Overview
This position supervises a team of USRNs to deliver accurate, high-quality clinical support and services for healthcare clients within a BPO setting. The role includes managing team performance, providing training and coaching, and ensuring compliance with HIPAA, client policies, and SLA standards.
Responsibilities
- Overseeing clinical processes such as utilization management, prior authorizations, appeals, and claims review.
- Monitoring KPIs related to quality, productivity, and turnaround times.
- Reviewing clinical decisions for accuracy and protocol adherence.
- Ensuring effective team performance and compliance with regulatory and client requirements.
Qualifications
- Active USRN license from any state
- At least one (1) year of experience in ER and/or ICU
- Leadership/supervisory background gained either in a clinical or BPO setting