Supervisor Clinical Denials

Title: Supervisor Clinical Denials

Location: Work From Home,Indiana

Job Description:

Full time

job requisition id: R-118817

Work From Home Work From Home, Indiana 46544

The Supervisor of Clinical Denials is responsible for the direct supervision of the daily operations of the Care Management Clinical Denials department to assure that denial management needs are addressed. This position will provide operational leadership to manage and maintain efficient denials management processes for Franciscan hospitals.
 
WHO WE ARE
With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve.
 
WHAT YOU CAN EXPECT

• Schedule: Monday - Friday, 8am - 5pm

• Oversee the claim denial appeal process; ensure appeals are appropriately documented, routed and filed as well as ensure appeals are followed-up in a timely manner and second level escalations occur as necessary. Outsource cases to appropriate areas when needed.

• Coordinate and maintain compliance with HFAP, state and federal agencies pertaining to Utilization/Denial management activities.

• Participate and educate team in performance improvement initiatives. Implement processes to satisfaction with those we are privileged to serve.

• Maintain inter-and intra-departmental communications, special projects, programs, policies, and procedures as well as clinical denial services.

• Supervise direct reports and manage the performance of individuals through ongoing coaching,

• feedback, and development to motivate, engage and drive a high performing team.

QUALIFICATIONS

• Bachelor's Degree in Nursing required 

• Active Indiana RN license required 

• 5 years of Nursing/Patient Care required 

• 2 years of Clinical Denials or Utilization Management experience required

TRAVEL IS REQUIRED:

Never or Rarely

JOB RANGE:

Supervisor Clinical Denials $71,094.40-$97,763.33

INCENTIVE:

Not Applicable

EQUAL OPPORTUNITY EMPLOYER

It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.

Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.

Franciscan Alliance is committed to equal employment opportunity.