Martin's Point Health Care
Clinical Supervisor Utilization Review - Remote
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Job Description
- Req#: REQ-2025-314
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to make a positive impact on patient care and organizational efficiency
- Engaging organizational culture that values trust, respect, and continuous learning
- Certified as a "Great Place to Work" since 2015
What to Expect (Job Responsibilities):
- Lead daily team huddles and manage day-to-day utilization review activities, including referral and authorization requests
- Mentor team members and assist with complex cases or questions, escalating issues as necessary
- Oversee training and onboarding of new utilization review team members
- Perform chart audits to ensure compliance with regulatory and accreditation standards
- Participate in program planning and identify improvement opportunities for utilization review processes
What is Required (Qualifications):
- Associate’s degree in nursing; Bachelor’s degree (BSN) preferred
- Minimum of 3 years of medical management experience in a managed care setting, including utilization review
- RN experience in a clinical setting
- Current Licensure as an RN in Maine and other appropriate jurisdictions as necessary
- Excellent interpersonal, verbal, and written communication skills
How to Stand Out (Preferred Qualifications):
- Leadership and/or management experience
- Certification in Managed Care Nursing
- Proficiency in Microsoft Office products, including Word, Excel, and Outlook
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