What are the responsibilities and job description for the Director of Clinical Review position at Insight Global?
Thank you so much for your interest! We're hiring a Clinical Director for a leading Healthcare system based out of NJ. This role will have 25 direct reports (5 admins / 20 UM and UR nurses) and will sit Hybrid out of a Hospital location in Camden NJ. The gap in recent interviews has been that candidates were more involved in Discharge Planning opposed to UM/UR nursing. This is a fast moving position (conducting interviews daily!) and our client would like to extend an offer ASAP!
Title: Director of Clinical Review
Location: Camden, NJ 08103
Schedule / Onsite Requirements: Mon-Fri 8am-430pm, fully onsite for first 90 days and then hybrid
Duration: PERM Direct Hire
Compensation: $140-150k/yr
Start Date: ASAP
Interview Process: 3 Rounds
Must Haves
- Bachelors Degree
- Current NJ RN license
- 4yrs experience in utilization management/review (UM/UR) or case management
- 2yrs managerial/leadership experience in a hospital setting with at least 8-10 direct reports
- Thorough understanding of InterQual/MCG/Medicare/Medicaid criteria (MUST HAVE knowledge of upcoming
- Epic EMR experience
Plusses
- BSN / MSN
- CCM, ANCC, or other related certification in Case Management preferred
Job Description
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.
Salary : $140,000 - $150,000
