Care Coordinator Supervisor, RN
About The Position
Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a career at Northside today. The UM/Appeals Supervisor Care Coordination RN is responsible for an appeals caseload and responsible for the Care Coordination staff for case reviews and UR appeals. Works with Appeals and Case review staff on a daily basis to resolve cases and provide guidance. Coordinates worklists and completion of cases on audit review, retro authorization and appeals. The training period will be conducted in person. Upon successful completion of training, the role will transition to a fully remote position. Please note that in-person meetings will be required throughout the year.
Requirements
- Nursing degree and three (3) years previous experience as hospital care coordinator or insurance case management.
- Current Standards of Care & Criteria, working knowledge of Intequal and/or Milliman.
- Ability to train and direct employees.
Nice To Haves
- Bachelor's degree in nursing.
- Five years of experience in care coordination or related field.
- Leadership experience preferred.
- Certification as Certified Case Manager (CCM), or Accredited Case Manager (ACM).
Responsibilities
- responsible for an appeals caseload
- responsible for the Care Coordination staff for case reviews and UR appeals
- Works with Appeals and Case review staff on a daily basis to resolve cases and provide guidance
- Coordinates worklists and completion of cases on audit review, retro authorization and appeals
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
Number of Employees
5,001-10,000 employees
