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RN Clinical Supervisor - Quality of Care QOC in Seven Hills, OH at KEPRO

Date Posted: 6/17/2018

Job Snapshot

Job Description

KEPRO is a rapidly growing national quality improvement and care management organization. We work to ensure that over 1 billion people receive the right care, at the right time, in the right setting.

 

RN ClinicalSupervisor - QOC

 

The RN Review Supervisor oversees and facilitates all assigned review staff and activities ensuring all reviews are thoroughly documented, investigated and responded to in a timely manner. The Supervisor is responsible for developing, monitoring, documenting and communicating all reporting as required.

  • Bachelors degree w/active, unrestricted RN license;
  • Minimum 3 years supervisory experience in a health-care field or directing/leading teams with a minimum of 2 - 3 years UM/UR experience required; 2 years recent clinical experience. 
  • Minimum 2 years’ experience in the management of quality reviews, appeals and/or fair hearings.  Risk management and/or legal claims review is also applicable. 
  • Experience representing a party or agency at state administered fair hearings or similar administrative hearings involving members; includes preparing position statements and other interactions in the fair hearing process.
  • Demonstrated adeptness at managing processes and actions required to resolve complaints, issues and grievances. Analytical, organizational and decision-making skills related to grievances and appeal resolution.
  • Demonstrated working knowledge of standards, as established by CMS and other regulatory agencies
  • Previous supervision\\workload management experience strongly preferred.
  • Knowledge of CQI tools 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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