Utilization Review Nurse Manager (USRN)

Provides front-line supervision to an operational team of 35 or more employees Supervised team typically responsible for manging US healthcare Payer claims adjudication process Assigns work to direct reports. Recommends and takes actions hiring, firing, promotion, and disciplinary recommendations. Supervises team ensuring the highest quality of service is provided to clients. Monitors performance of the team and reports results and issues to higher-level leadership. Assists team with escalated client or account issues. Manages hiring, staffing and maintaining a diverse and effective workforce. Interacts with clients and internal departments to resolve issues. Works with the team to complete assignments using established guidelines, policies and procedures. Demonstrates professional courtesy and represents the company in a positive manner in all areas of internal and external communications. Ensures appropriate record keeping, reports, and related administrative functions are accurate and up-to-date. Responsible for career development / planning, performance and pay discussions of team members. Upon request, compiles and analyses data to identify trends for root cause analysis. Typically requires 5- 9 years relevant experience Should be open to work in night shifts Undergraduate degree or equivalent combination of education and work experience. Solid communication skills. Demonstrated client service skills and leadership capabilities. Good knowledge, understanding and application of project management principles and methodologies. Models excellent analytical / problem solving skills. Good client service skills and leadership capabilities Solid analytical / problem solving skills.