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
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