[Remote] Associate Manager, Clinical Review

Note: The job is a remote job and is open to candidates in USA. Gainwell Technologies is seeking an Associate Manager, Clinical Review who will supervise the day-to-day operations of a multidisciplinary team involved in clinical claim reviews. This role includes overseeing staff performance, ensuring productivity, and managing client interactions to enhance service delivery and efficiency.ResponsibilitiesResponsible for oversight and hiring of staff, retaining top talent, performance management, coordinating training and education, and providing leadership and mentorship to staff to build and improve skills to provide best-in-class practices to enhance efficiency, quality, and customer satisfactionMonitor aging inventory, workload, assignments, productivity, and quality to ensure service level agreements, contract deliverables, and timelines are metEvaluate and analyze productivity, utilization, efficiency, finding rates, savings, appeal overturn rate, and reviews completed by staff to identify opportunities for process improvementsMeet with clients and providers to discuss complex cases, trend analysis, exit and/or settlement conferencesServe as a Subject Matter Expert to assess new tools, automation, product development, and clinical readiness; act as a resource for resolving escalated issues, and coach and mentor staff to develop a high-performing teamAnalyze reports and data and identify trends and resources that improve the delivery of clinical review servicesManage and evaluate individual/team performance and take appropriate action to meet and/or exceed performance standardsPerform other functions as assignedSkillsActive, Unrestricted RN license from the United States and in the primary home residency, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC)5+ year's healthcare experience with increasing responsibility required3+ year's utilization review or health care auditing experience requiredDemonstrates a thorough understanding of clinical criteria and clinical review judgmentBachelor's degree in business, healthcare administration, or related field preferred2+ year's management or supervisory experience preferredBenefitsAll salaried, full-time candidates are eligible for our generous, flexible vacation policyA 401(k) employer matchComprehensive health benefitsEducational assistanceA variety of leadership and technical development academies to help build your skills and capabilitiesCompany OverviewGainwell Technologies is a provider of Information Technology & Services. It is a sub-organization of Veritas Capital. It was founded in 2009, and is headquartered in Irving, Texas, USA, with a workforce of 10001+ employees. Its website is https://www.gainwelltechnologies.com/.