Care Coordinator Supervisor, RN
Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a career at Northside today.
Responsibilities:The UM/Appeals Supervisor Care Coordination RN is responsible for an appeals caseload and responsible for the Care Coordination staff for case reviews and UR appeals. Works with Appeals and Case review staff on a daily basis to resolve cases and provide guidance. Coordinates worklists and completion of cases on audit review, retro authorization and appeals.
- The training period will be conducted in person. Upon successful completion of training, the role will transition to a fully remote position. Please note that in-person meetings will be required throughout the year.
REQUIRED: 1. Nursing degree and three (3) years previous experience as hospital care coordinator or insurance case management.
2. Current Standards of Care & Criteria, working knowledge of Intequal and/or Milliman.
3. Ability to train and direct employees.
PREFERRED: 1. Bachelor's degree in nursing. Five years of experience in care coordination or related field. Leadership experience preferred.
2. Certification as Certified Case Manager (CCM), or Accredited Case Manager (ACM).
Work Hours:: 8am - 4:30pm Weekend Requirements:: No On-Call Requirements:: Yes Apply To This Job