Supervisor, Clinical Review Nurse

apartment TurningPoint location_onLake Mary, FL 32746, US

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Position: Supervisor, Clinical Review Nurse

Location:

Any

Job Id: 676

# of Openings: 1

Job Description

TurningPoint is an innovative healthcare services and technology organization that is committed to working with Health Plans and Providers to develop advanced technical and clinical solutions that improve the quality and affordability of surgical care patients receive. We are seeking a highly motivated and results orientated Nurse Supervisor to join our fast-paced and rapidly growing company.

Primary Responsibilities

This position is responsible for Utilization Management (UM) activities, including but not limited to the supervision of UM and Prior Authorization clinical team processes. This individual develops, implements, supports and promotes managed care strategies, policies and programs that drive the delivery of quality healthcare.

Providing leadership and demonstrating responsibility and accountability for the delivery of quality services to a team of clinical staff

Reviewing pre-authorization requests for appropriateness of care within established evidence-based criteria sets

Interacting with other TurningPoint personnel to assure quality customer service is provided.

Acting as an internal resource by answering questions requiring clinical interpretation

Identifying high cost utilization and making appropriate referral

Assisting the Director of Utilization Management in developing guidelines and procedures for the department

Skills, Education & Experience Requirements

An active and unrestricted Registered Nurse (RN)

Associate’s Degree is required. Bachelor of Science in Nursing (BSN) Degree is preferred

Five (5) years of clinical experience; or any combination of education and experience, which would provide an equivalent background

Experience in surgical utilization review, pain management, case management, or health insurance pre-authorization and/or utilization management

Minimum of 3 years experience Supervising and Managing a team of clinical and non-clinical staff members

Ability to function effectively in an interdisciplinary team that includes physicians, nurses, other healthcare personnel and administrative staff

Ability to work independently with minimal supervision

Ability to organize, prioritize and complete work in a timely manner despite many deadlines and competing priorities

Benefits

TurningPoint offers a number of benefits to full-time employees including, but not limited to: medical, dental, vision, disability, life, PTO. All employees, age 21 and over, are eligible to participate in the 401(k)-retirement savings plan.

Job Type: Full-time

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