Nurse Audit Supervisor

About the role

Supervise the Nurse Audit team, acting as a resource for staff, and coordinate activities to ensure delivery of medically necessary, cost-effective, quality care.

Responsibilities

• Ensure medical payments align with contract provisions, proper coding, and policy compliance.
• Oversee team work outputs, priorities, and timelines.
• Communicate effectively with members, providers, and employer groups.
• Lead and develop a team, including remote staff.
• Recognize and resolve complex issues related to clinical utilization and care management practices.

Requirements

• Bachelor’s degree in Nursing or related field.
• 3+ years of leadership experience and 5+ years of clinical experience.
• Registered Nurse licensure in WA, OR, UT, or ID.
• AHIMA credentials preferred.
• Extensive knowledge of ICD-10 coding, claim reimbursement, and health insurance trends.
• Strong communication, problem-solving, and team leadership skills.