Clinical Denials Supervisor, RN

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.

he 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.

• This is a fully remote position with work in the office responsibilities for new hire training once fully orientated.
• Must be willing to train in Sandy Springs Interchange location.

REQUIRED:
1. Nursing degree and three (3) years previous experience as hospital care coordinator or insurance case management.

2. Current Standards of Care & Criteria, working knowledge of Intequal and/or Milliman.

3. Ability to train and direct employees.
PREFERRED:
1. Bachelor's degree in nursing. Five years of experience in care coordination or related field. Leadership experience preferred.

2. Certification as Certified Case Manager (CCM), or Accredited Case Manager (ACM).