Clinical Supervisor (RN) - (Remote in Indiana)

Company: Keystone Peer Review Organization, Inc.
Location: Indianapolis
Posted on: May 27, 2023

Job Description:

Clinical Supervisor (RN)

• Are you an experienced Clinical Supervisor looking for a new challenge?
• Do you value utilization review and quality assurance?
• Are you motivated, energetic, and excited to become part of the Kepro team? If so, you might be our next new team member! Who we need: The Clinical Supervisor is responsible for the management and oversight of Indiana Utilization Management activities. Oversees clinical program activities to ensure overall consistency, thoroughness, and accuracy of the clinical programs. Oversees program to ensure clinical efficiencies, deliverables and assigned contract functions are performed to the highest standards to strengthen the relationships with customers and meet contract requirements. Provides day-to-day oversight to manage the utilization review program. Why us? Kepro is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting. People Focused. Mission Driven. Shape the future of healthcare with us. We are mission driven to improve lives through healthcare quality and clinical expertise. We do this through our people. At Kepro, you can do meaningful work that makes a real difference for the lives of individuals across the country. We are an organization that cares deeply about our employees, and we provide the training and support to do the best work of your career. Benefits are a key component of your rewards package at Kepro. These benefits are designed to provide you and your family additional protection, security, and support for both your career and your life away from work. They are comprehensive and fit a variety of needs and situations. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts and more. What you'll do:
  • Responsible for utilization reviews as defined by the contract to include prior authorization and retro reviews.
  • Oversees utilization review activities.
  • Serve as a Subject Matter Expert (SME). The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time. What you'll need: Required Qualifications
    • Active, unrestricted Licensed RN in Indiana or compact license.
    • Associate's Degree or equivalent directly applicable experience in nursing, healthcare administration or related area.
    • Bachelor's degree preferred. Knowledge, Skills, Abilities
      • Excellent verbal and written communication skills essential.
      • Current working knowledge of utilization management.
      • Customer-focused, results-oriented, and capable of building and maintaining relationships with internal and external customers.
      • Organizational skills, ability to plan and prioritize multiple assignments essential.
      • Current Interqual and Milliman criteria knowledge.
      • Experience in using systems that support Utilization Review processing.
      • Ability to participate as a team member fostering collaborative decision-making among leadership, committees, teams, or work groups of diverse composition.
      • Computer proficiency in Microsoft Office applications and other software programs essential to perform job functions.
      • Ability to provide technical guidance and leadership to management team. Experience
        • Five (5) years of experience in a lead position in a quality and utilization management program including two (2) most recent years being in health care management. Thank You! We know your time is valuable and we thank you in advance for applying for this position. Due to the high volume of applicants we receive, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Kepro and invite you to apply to future openings that may be of interest. Best of luck in your search! - The Kepro Talent Acquisition Team Mental and Physical Requirements The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state. EOE AA M/F/Vet/Disability Kepro is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Keywords: Keystone Peer Review Organization, Inc., Indianapolis , Clinical Supervisor (RN) - (Remote in Indiana), Healthcare , Indianapolis, Indiana