Oregon Licensed Utilization Review Supervisor

A company is looking for a Supervisor of Utilization Review (Case Management). Key Responsibilities Oversee daily operations of the utilization review team, ensuring compliance with payer guidelines Provide leadership, training, and guidance to utilization review staff Collaborate with clinical teams and payer representatives to minimize denials and improve reimbursement outcomes Required Qualifications A minimum of 2 years of leadership experience in utilization review or clinical documentation integrity An additional 2 years of nursing experience in clinical practice areas Preferred Bachelor's degree in nursing or equivalent education and experience Registered Nurse (RN) licensure by the Oregon State Board of Nursing or equivalent Preferred certifications include CCM, ACM, CCS, CPC, CCS-P, or CRC

Mar 15, 2025 - 05:16

A company is looking for a Supervisor of Utilization Review (Case Management). Key Responsibilities Oversee daily operations of the utilization review team, ensuring compliance with payer guidelines Provide leadership, training, and guidance to utilization review staff Collaborate with clinical teams and payer representatives to minimize denials and improve reimbursement outcomes Required Qualifications A minimum of 2 years of leadership experience in utilization review or clinical documentation integrity An additional 2 years of nursing experience in clinical practice areas Preferred Bachelor's degree in nursing or equivalent education and experience Registered Nurse (RN) licensure by the Oregon State Board of Nursing or equivalent Preferred certifications include CCM, ACM, CCS, CPC, CCS-P, or CRC