A large health system in southern New Jersey is searching for a Director of Clinical Review to join their team. The Director of Clinical Review manages both administrative and clinical review tasks for the revenue cycle organization. Administrative functions can include: recruitment and retention (hiring), payroll tracking, overall scheduling duties, maintaining current team budget and assisting in future budget projections, and overall performance management. The Director of Clinical Review will ideally come from a career as a Utilization Review/Management nurse, and have moved up through the ranks pursuing leadership and growth. This director must have a solid understanding and experience with denial mitigation, insurance guidelines, commercial and government payers, and Interqual/MCG criteria. This team operates in EPIC EMR, so experience with this system is extremely important to contribute to the success of the team. We are searching for a director that lives and breathes case management.
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Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.