Nurse Team Lead - Clin Rev

STANDARD DEPARTMENTAL RESPONSIBILITIES
• Provide secondary Nursing Management coverage for assisting staff during Manager or Supervisor unavailability due to meetings, PTO, etc.
• Handles escalated inbound calls or requests from providers
• Assists with inventory management, including monitoring case volumes and queues to support timely assignment and completion
• Actively participates or conducts meetings as directed by Supervisor or Manager
• Develop, implement, and utilize a multifaceted rewards system that makes team members excited to show up to work every day and do their best
• Use empowerment, trust and other strategies as appropriate to develop and motivate team members
• Facilitate a healthy and motivating work environment and atmosphere
• Utilizes knowledge of AVAYA, ADP Workforcenow. and related systems to manage daily phone metrics
• Capable of collaborating with client personnel to resolve customers’ concerns
• Responsible for knowing the intricacies of all benefit management programs including applicable regulatory compliance, accreditation standards, and client/health plan service level requirements for each program, line of business, and geographic region
• Refers all complaints to Compliance Officer, as appropriate; works collaboratively with the Quality Department to investigate complaints and correct errors
• Evaluate and report HIPAA breaches according to policy
• Collaborates with human resources to ensure adherence to company policies
• Promotes business focus which demonstrates an understanding of the company’s vision, mission, and strategy
• Creates, encourages, and supports an environment that fosters teamwork, respect, diversity, and cooperation with others
• Adheres to all HIPAA, state and federal regulations pertaining to the clinical programs
• Adheres to both URAC & NCQA standards pertinent to their job description
• Performs other related duties and projects as assigned

• Please note this job description is not designed to cover or contain a comprehensive list of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

QUALIFICATIONS
• Graduate of an accredited school of nursing
• Current active, unrestricted RN or LVN/LPN license in a state or territory of the United States required
• Minimum of 2 years of Utilization Management (UM) experience required; additional experience in QM, acute care, or managed care setting preferred
• Excellent interpersonal, written and presentation skills, including the ability to handle interactions with facility personnel, providers, members and various internal departments in a professional manner
• Demonstrates leadership and motivational skills
• Ability to work in a fast-paced, evolving environment, on-call after hours work may be required
• Ability to utilize critical thinking skills
• Experience in team interactions and improvement methods/projects (e.g., coaching quality and productivity)
• Understanding of HealthHelp’s products and services
• Strong interpersonal and communication skills
• Knowledge of Microsoft Office and programs including Outlook, PowerPoint, Excel, Word and Visio

ENVIRONMENT AND PHYSICAL DEMANDS
• Business office environment or HIPAA compliant remote location
• Ability to use telephone for up to 8 hours unassisted
• Ability to sit for up to 8 hours unassisted
• Ability to enter data for up to 8 hours unassisted
• Ability to view PC screen for up to 8 hours
• Ability to prioritize in a multi-task environment

Shift 10:30am - 7:00pm

Compensation Disclosure

The base salary for this position is LVN/LPN Team Lead $74,880 and RN Team Lead $85,280 annually. This represents the base pay range that we reasonably expect to offer for this position.

In addition to base pay, this role may be eligible for performance-based bonuses, incentive pay, or commissions, which are not included in the listed base salary range.

WNS complies with all applicable federal, state, and local pay transparency laws, including those in California, Colorado, New York, Washington, and Illinois.

Note: For complete compensation information, please refer to the job posting on our official careers page.

Equal Opportunity Employer Statement

WNS is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, genetic information, veteran status, or any other status protected under federal, state, or local law.

We also provide reasonable accommodations to individuals with disabilities and for sincerely held religious beliefs in all aspects of employment, including the application process.

Benefits Overview

Our benefits package includes (but is not limited to):

- Medical, dental, and vision insurance

- Paid time off (PTO), holidays, and sick leave

- 401(k) with company match or other retirement plan

- Life and AD&D Insurance

- Employee Assistance Program

Equal Opportunity Employer Statement

WNS is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, genetic information, veteran status, or any other status protected under federal, state, or local law.

We also provide reasonable accommodations to individuals with disabilities and for sincerely held religious beliefs in all aspects of employment, including the application process.

How to Apply

Please submit your application, including a resume and optional cover letter, through our careers page or email to talent@healthhelp.com.