Medical Claims Review Manager oversees the performance, productivity, and quality of the medical claims review staff. Responsible for hiring, training, and firing medical claims review staff. Being a Medical Claims Review Manager evaluates medical claims review processes and recommends process improvements. Serves as a technical resource for all medical review workers. Additionally, Medical Claims Review Manager typically requires an RN or BSN. Requires a bachelor's degree. Typically reports to a head of a unit/department. The Medical Claims Review Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Medical Claims Review Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)
Quality Coordinator (RN) - Peer Review is a Full Time position working Mon- Friday at Northwest Medical Center What You'll do: Quality Coordinator (RN) - Peer Review will coordinate provider peer review process for the Executive Committee for the Department of Medicine, Executive Committee for the Department of Surgery and Anesthesia, as well as our Allied Health Providers. Requires Associate's degree, at least 3 years of acute clinical experience , and is licensed as a registered nurse.
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