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Manager, Operations RN - Healthcare in Seven Hills, OH at KEPRO

Date Posted: 4/3/2018

Job Snapshot

Job Description

Manager, Operations - Healthcare

Oversee and coordinate non-physician review activities as established in the contract.  Develop and analyze management reports about productivity, accuracy and reliability relative to all review activities.  Manage contract review related activities and oversee the entire team of non-physician reviewers assuring initiation, timely and accurate completion of a broad range of waiver services and reconsideration appeals reviews.  Assist in development and preparation of report summaries, etc.  Functions as providers’ liaison and contact/resource person for provider customer service issues and problem resolution. Role involves heavy client contact so the ability to maintain effective customer rapport and develop and implement programs to build and maintain positive customer relationships is paramount. 

Qualifications:               

  •      Bachelor's degree and active/unrestricted RN license required 
  •      8+ years of professional experience with at least 5 years broad health care management experience.
  •      Experience with UM, QOC and/or Appeals required.  
  •      Previous supervision\\workload management experience strongly preferred.
  •      Excellent communication, organization & team building skills plus a strong focus on customer service & provider relations required.  
  •    Ability to interact effectively with internal and external customers in a professional and courteous manner. 
  •      Ability to handles multiple tasks and adjust to changing priorities.
  •      Must be proficient in MS Office applications 

 KEPRO offers challenging careers, excellent benefits and opportunities for advancement.  For consideration, please submit resume and cover letter with salary requirements. Only those candidates identified for an interview will be contacted. No Phone Calls Please.  Visit our website at www.KEPRO.com for more information on the KEPRO Family of Companies.   

EOE AA M/F/Vet/Disability

KEPRO is an E-Verify employer. E-Verify is an internet based system operated by the Department of Homeland Security (DHS) in partnership with the Social Security Administration (SSA) that allows participating employers to electronically verify the employment eligibility of their newly hired employees in the United States.

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