Senior Manager, Customer Centricity – Business Cards & Payments
Capital One
Associate Manager, Clinical Review
Gainwell Technologies
full-time
Posted on:
Location Type: Remote
Location: Remote • Maine • 🇺🇸 United States
Visit company websiteSalary
💰 $80,000 - $99,000 per year
Job Level
JuniorMid-Level
About the role
- Responsible for supervising the day-to-day prepay, post-pay, prior authorization, and utilization review activities of a multidisciplinary team
- Oversee and manage daily operations of the team by leading, assigning work, ensuring productivity and quality metrics are achieved
- Analyze productivity, utilization, efficiency, finding rates, savings, and appeal overturn rates
- Serve as a Subject Matter Expert to assess new tools, automation, product development, and clinical readiness
- Monitor aging inventory, workload, assignments, and productivity
Requirements
- Active, Unrestricted RN license from the United States
- Bachelor’s degree in business, healthcare administration, or related field preferred
- 5+ year’s healthcare experience with increasing responsibility required
- 3+ year’s utilization review or health care auditing experience required
- 2+ year’s management or supervisory experience preferred
- Demonstrates a thorough understanding of clinical criteria and clinical review judgment.
Benefits
- Comprehensive health benefits
- 401(k) employer match
- Flexible vacation policy
- Educational assistance
- Leadership and technical development academies
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
utilization reviewhealth care auditingclinical review judgmentproductivity analysisefficiency analysissavings analysisappeal overturn rates analysis
Soft skills
leadershipteam managementassigning workensuring productivityquality metrics achievement
Certifications
Active RN license
