On-site
Full Time
Qualified NCLEX RN/ USRN
Experience in US healthcare process
Must have experience in handling teams
Must have experience in handling client feedback and escalations
Familiarity with basic medical terminology and concepts used in care management
Implements clinical policies & procedures in accordance with NCQA, URAC, state and federal standards and mandates
Effectively forecast and manage the process volume, allocation, and staffing following the Statement of Work on a daily basis
Maintain accurate reporting and cascading of information to internal and external stakeholders
Update mandatory process trackers and files for compliance purposes
EXL
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