RN Supervisor of Appeals

Job Summary

A company is looking for a Supervisor, Appeals to oversee the utilization management team and ensure appropriate care for members.

Key Responsibilities

• Supervises the day-to-day activities of the utilization management team
• Monitors compliance with performance, quality, and efficiency standards
• Collaborates with the team to resolve complex member care issues

Required Qualifications

• Graduate of an Accredited School of Nursing or Bachelor's degree
• 4+ years of related experience in utilization management
• RN - Registered Nurse - Compact State Licensure required
• Knowledge of utilization management and appeals principles preferred