South Carolina Licensed Medical Review Supervisor

A company is looking for a Medical Review Supervisor to lead a team of medical reviewers working with Medicare Part A cases. Key Responsibilities Manage daily activities and supervise a team of medical reviewers, ensuring accurate workflow and training needs are met Perform quality control functions, develop work plans for quality improvement, and prepare reports Develop and maintain procedures for audits, set department standards, and coordinate special projects Required Qualifications Associate's degree in a job-related field or equivalent nursing education Five years of clinical nursing or utilization review experience, with three years in a clinical setting One year of leadership experience or equivalent military experience at grade E4 or above Active, unrestricted RN licensure in the state of hire or compact multistate RN license Proficiency in Microsoft Office and knowledge of healthcare delivery systems

Apr 18, 2025 - 20:30

A company is looking for a Medical Review Supervisor to lead a team of medical reviewers working with Medicare Part A cases. Key Responsibilities Manage daily activities and supervise a team of medical reviewers, ensuring accurate workflow and training needs are met Perform quality control functions, develop work plans for quality improvement, and prepare reports Develop and maintain procedures for audits, set department standards, and coordinate special projects Required Qualifications Associate's degree in a job-related field or equivalent nursing education Five years of clinical nursing or utilization review experience, with three years in a clinical setting One year of leadership experience or equivalent military experience at grade E4 or above Active, unrestricted RN licensure in the state of hire or compact multistate RN license Proficiency in Microsoft Office and knowledge of healthcare delivery systems