Clinical Supervisor - RN (Remote within Indiana preferred) - Indianapolis, IN, United States

Company Description

CNSI and Kepro are now Acentra Health! Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the company’s mission, actively engage in problem-solving, and take ownership of your work daily. Acentra Health offers unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes, making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Job Description

Acentra seeks a Clinical Supervisor – RN (Remote within Indiana preferred) to join our growing team.

Job Summary:

The Clinical Supervisor – RN is responsible for the management and oversight of the:

• Indiana Utilization Management activities.
• Clinical program activities to ensure overall consistency, thoroughness, and accuracy of the clinical programs.
• Program to ensure clinical efficiencies, deliverables, and assigned contract functions are performed to the highest standards to strengthen the relationships with customers and meet contract requirements.
• Day-to-day oversight to manage the Utilization Review (UR) program and clinical staff to ensure that contractual deliverables are met. 

** It is preferred that the selected candidate reside and work in the state of Indiana. **

Job Responsibilities:

• Utilization reviews, as defined by the contract, including prior authorization and retro reviews.
• Oversee utilization review activities.
• Serve as a Subject Matter Expert (SME).

The above list of accountabilities is not intended to be all-inclusive.  It may be expanded to include other duties that management may deem necessary from time to time.

Qualifications

Required Qualifications/Experience:

• Active, unrestricted Licensed RN in Indiana OR a Compact State License.
• Associate’s Degree or equivalent, directly applicable, experience in nursing, healthcare administration, or a related area.
• 5+ years of experience in a Lead position in a Quality and Utilization Management program, including the two (2) most recent years being in healthcare management.
• Knowledge of current InterQual and Milliman Care Guidelines criteria.
• Experience in using systems that support Utilization Review processing.
• Ability to participate as a team member, fostering collaborative decision-making among leadership, committees, teams, or work groups of diverse composition.
• Computer proficiency in Microsoft Office applications and other software programs essential to perform job functions.
• Ability to provide technical guidance and leadership to the management team.

Preferred Qualifications/Experience:

• Bachelor's degree.

Experience with following Utilization Review Accreditation Commission (URAC) guidelines.

Compensation

The pay range for this position is $80,000.00-85,000.00 annually.

“Based on our compensation philosophy, an applicant’s placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.”

Additional Information

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives nationwide. Our company cares about our employees, giving you the tools and encouragement you need to achieve the finest work of your career.

Thank You!

We know your time is valuable, and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may interest you. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

Visit us at Acentra.com/careers/

EOE AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable Federal, State, or Local law.

Benefits are a key component of your rewards package. Our benefits are designed to provide additional protection, security, and support for your career and life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.