NHS Solutions seeks an experienced Interim Clinical Appeals Supervisor. The successful candidate will coordinate and execute the appeal process for all facilities clinical appeals and third-party audits, supervise Care Management Specialist workflow for referral, post hospital appointments and utilization management activities for inpatients.
- Graduate of an accredited nursing program, BSN preferred
- 5 years of acute care nursing including medicine/surgery, ICU, telemetry or 5 years of case management experience in an acute setting or utilization review at a medical group or health plan
- CA RN license
- CCMC or ACM preferred