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Hr Medical Review Supervisor (Onsite In Columbia, Sc)

Company

BlueCross BlueShield of South Carolina
Address , Columbia, Sc
Employment type FULL_TIME
Salary
Expires 2023-07-17
Posted at 11 months ago
Job Description
Summary
This position supervises the administration of leave of absence (FMLA) and ADA accommodations.
.
Responsible for the supervision and maintenance of the daily functions of Utilization Review/Review Nurses, Case Management, and/or Medical Review staff and specialty programs. Ensures appropriate levels of healthcare services are provided.

Description

Logistics:
  • This position is onsite in our Columbia, SC office on Clemson Road.
  • Work hours are generally 8:00 am to 5:00 pm Monday through Friday.
What you will do:
  • Develops/maintains/updates procedures/documentation for conducting audits. Develops/communicates department standards and expectations of staff. Coordinates special projects, system testing enhancements, etc.
  • Supervises staff to include approval of time, leave, performance reviews, etc. Selects/trains/motivates staff in providing excellent customer service with customers, marketing, management/others.
  • Manages day-to-day activities for assigned staff. Identifies training needs and verifies accuracy and timeliness of workflow functions.
  • Performs quality control functions for work performed. Develops work plans to improve quality performance. Prepares/reviews/maintains weekly/monthly reports.
What you need to qualify:
  • One year team lead/leadership role OR equivalent military experience in grade E4 or above (may be concurrent with the five years clinical experience).
  • Associate Degree - Nursing, OR Graduate of Accredited School of Nursing.
  • Active, unrestricted RN licensure from the United States and in the state of hire, OR, active, compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC), OR, active, unrestricted licensure/certification from the United States and in the state of hire in specialty area as required by hiring division/area
  • Five years clinical OR five years utilization review/medical review experience (three of the five must be clinical).
  • Microsoft Office.
What we prefer you have:
  • Experience with ADA, FMLA, leave of absence, employee health and/or occupational health.
What We Can Do for You:
We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have access and opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
Our comprehensive benefits package includes:
  • Fantastic health plans and free vision coverage
  • Paid annual leave — the longer you work here, the more you earn
  • Tuition assistance
  • On-site cafeterias and fitness centers in major locations
  • Service recognition
  • Wellness programs and a healthy lifestyle premium discount
  • Nine paid holidays
  • Life insurance
  • 401(k) retirement savings plan with company match
What to Expect Next:
After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Management will be conducting interviews with the most qualified candidates.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.
Equal Employment Opportunity Statement
BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains Affirmative Action programs to promote employment opportunities for minorities, females, disabled individuals and veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.
We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities.
If you need special assistance or an accommodation while seeking employment, please e-mail [email protected] or call 1-800-288-2227, ext. 43172 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.