Are you an expert in the managed care arena? Are you licensed as a registered nurse? Are you familiar with URAC and NCQA requirements? Are you familiar with Interqual, Milliman, CMS, and other medical necessity? Do you have strong leadership and supervisory experience? Do you have training experience? Are you able to perform quality audits, participate in process reviews, and prepare reports/conduct analyses of operations, authorizations, and appeals? BHM Healthcare Solutions has an exciting remote work opportunity for an RN, IRO Clinical Manager, who will assist the company with the growth and maintenance of our Peer Review/Physician Advisor service line.
The RN, IRO Clinical Manager will supervise a team. He/she will lead the development and implementation of the program, and be responsible for effective collaboration with internal and external resources to achieve goals and objectives. Individuals must have advanced knowledge and skills in clinical management, and will lead a variety of activities related to the program.
BHM Healthcare Solutions is an Independent Review Organization and is URAC accredited for both internal and external reviews. BHM’s product speaks for itself with the highest ranking in the industry for customer satisfaction, 100% for three years in a row. The breadth of reviews includes both standard and expedited as well as concurrent, retrospective and prospective. BHM’s physician base spans over both medical and behavioral health with physician reviewers located in all 50 states and covering just about every board certification. One reason BHM has been so successful is their proprietary Peer Review Portal designed to streamline and automate the peer review process, while ensuring compliance with all federal and state regulations, including URAC and HIPAA. Innovation is key to BHM’s success with frequent upgrades to the portal based upon customer feedback.
Join BHM's team today!