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

Date Posted: 2/3/2018

Job Snapshot

Job Description

Manager, Operations - Healthcare

Overseeand coordinate non-physician review activities as established in thecontract.  Develop and analyze management reports about productivity,accuracy and reliability relative to all review activities.  Managecontract review related activities and oversee the entire team of non-physicianreviewers assuring initiation, timely and accurate completion of a broad rangeof waiver services and reconsideration appeals reviews.  Assist indevelopment and preparation of report summaries, etc. Functions as providers’ liaison andcontact/resource person for provider customer service issues and problemresolution. Role involves heavy client contact so the ability to maintaineffective customer rapport and develop and implement programs to build andmaintain 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 broadhealth care management experience.
  •      Experiencewith UM, QOC and/or Appeals required.  
  •      Previoussupervision\workload management experience strongly preferred.
  •      Excellentcommunication, organization & team building skills plus a strong focus oncustomer service & provider relations required.  
  •    Abilityto interact effectively with internal and external customers in a professionaland courteous manner. 
  •      Abilityto handles multiple tasks and adjust to changing priorities.
  •      Mustbe proficient in MS Office applications 

 KEPROoffers challenging careers, excellent benefits and opportunities foradvancement.  For consideration, please submit resume and cover letterwith salary requirements. Only those candidates identified for aninterview will be contacted. No Phone Calls Please.  Visit our website at www.KEPRO.com for more information on the KEPROFamily of Companies.   

EOE AA M/F/Vet/Disability

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

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