Supervisor Nurse Audit

Supervisor Nurse Audit will oversee and coordinate team activities to achieve business objectives and ensure medically necessary, cost-effective, quality care is delivered to members. The ideal candidate will have Clinical Supervisory experience from another health insurance plan in addition to having auditing and potentially coding experience.

Requirements

• Supervise the Nurse Audit team and acts as a resource for professional and support staff
• Oversees and coordinates team activities to achieve business objectives
• Ensures medically necessary, cost-effective, quality care is delivered to members
• Ensures medical payments are appropriate and in alignment with contract provisions, proper coding and policy compliance
• Ability to communicate effectively, verbally and in writing including with members, employer or provider groups