Supervisor State Arbitration
Description & Requirements
Maximus is currently hiring for a Supervisor to join our State Arbitration team. This is a remote opportunity. The Supervisor is responsible for overseeing and managing the staff involved in the IDRE program. Additionally, they will be responsible for performing stability checks and back-end quality review.
Essential Duties and Responsibilities:
- Provide supervision and clinical oversight to team of direct reports.
- Discuss job performance concerns with direct reports to identify causes and issues and work closely with the HR department on resolving problems.
- Conduct case reviews and consultations as needed; identify need for escalation to management, physician or related disciplines
- Serve as subject matter expert on area of clinical knowledge including training and education
- On contract requiring assessments, may conduct assessments or field training of assessors as needed
- Instruct, demonstrate, observe skills and techniques of nursing staff and provide feedback to management. .
- May attend client and stakeholder meetings
- Performs other related duties as assigned.
Required Skills/Abilities:
- Subject Matter knowledge in area of contract operations
- Ability to identify and prioritize tasks based on level of time sensitivity and/or potential health and safety concerns
- Supervise and manage the staff involved in the IDRE program.
- Ensure that all dispute cases are reviewed and processed in a timely and accurate manner.
- Collaborate with healthcare providers, health plans, and other stakeholders to facilitate the resolution of disputes.
- Maintain detailed records of all cases and ensure compliance with HIPAA and other regulatory requirements.
- Monitor and evaluate the performance of staff, providing feedback and coaching as needed.
- Stay informed about current trends and best practices in healthcare billing and dispute resolution.
Minimum Requirements:
- Current Registered Nurse (RN) license valid in the state of practice is required-
-Bachelorās degree preferred, High School Degree or equivalent required
- Minimum of 2 years of nursing experience.
- Prior experience with clinical supervision or as a charge nurse preferred.
- Experience in healthcare billing, coding, or dispute resolution is highly preferred.
- Nursing experience in an ICU or ER setting preferred.
- Ability to commit to a training schedule between the hours of 8:00am - 5:00pm EST Monday - Friday required.
- Excellent communication and interpersonal skills.
- Ability to work independently and make informed decisions.
- Detail-oriented with strong organizational skills.
- Strong problem-solving skills and ability to handle high-pressure situations.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 20mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net )
- Minimum 5mpbs upload speed
- Connectivity to the in ternet via either Wi-Fi or Category 5 or 6 ethernet patch cable to the home router
- Private work area and adequate power source
- Must currently and permanently reside in the Continental US
EEO Statement
Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.
Minimum Salary
$70,000.00
Maximum Salary
$80,000.00
Compensation: $70,000-$80,000 per year
Remote: Yes
Apply Now
Maximus is currently hiring for a Supervisor to join our State Arbitration team. This is a remote opportunity. The Supervisor is responsible for overseeing and managing the staff involved in the IDRE program. Additionally, they will be responsible for performing stability checks and back-end quality review.
Essential Duties and Responsibilities:
- Provide supervision and clinical oversight to team of direct reports.
- Discuss job performance concerns with direct reports to identify causes and issues and work closely with the HR department on resolving problems.
- Conduct case reviews and consultations as needed; identify need for escalation to management, physician or related disciplines
- Serve as subject matter expert on area of clinical knowledge including training and education
- On contract requiring assessments, may conduct assessments or field training of assessors as needed
- Instruct, demonstrate, observe skills and techniques of nursing staff and provide feedback to management. .
- May attend client and stakeholder meetings
- Performs other related duties as assigned.
Required Skills/Abilities:
- Subject Matter knowledge in area of contract operations
- Ability to identify and prioritize tasks based on level of time sensitivity and/or potential health and safety concerns
- Supervise and manage the staff involved in the IDRE program.
- Ensure that all dispute cases are reviewed and processed in a timely and accurate manner.
- Collaborate with healthcare providers, health plans, and other stakeholders to facilitate the resolution of disputes.
- Maintain detailed records of all cases and ensure compliance with HIPAA and other regulatory requirements.
- Monitor and evaluate the performance of staff, providing feedback and coaching as needed.
- Stay informed about current trends and best practices in healthcare billing and dispute resolution.
Minimum Requirements:
- Current Registered Nurse (RN) license valid in the state of practice is required-
-Bachelorās degree preferred, High School Degree or equivalent required
- Minimum of 2 years of nursing experience.
- Prior experience with clinical supervision or as a charge nurse preferred.
- Experience in healthcare billing, coding, or dispute resolution is highly preferred.
- Nursing experience in an ICU or ER setting preferred.
- Ability to commit to a training schedule between the hours of 8:00am - 5:00pm EST Monday - Friday required.
- Excellent communication and interpersonal skills.
- Ability to work independently and make informed decisions.
- Detail-oriented with strong organizational skills.
- Strong problem-solving skills and ability to handle high-pressure situations.
Please note: For this position Maximus will provide equipment to use.
Home Office Requirements:
- Internet speed of 20mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net )
- Minimum 5mpbs upload speed
- Connectivity to the in ternet via either Wi-Fi or Category 5 or 6 ethernet patch cable to the home router
- Private work area and adequate power source
- Must currently and permanently reside in the Continental US
EEO Statement
Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.
Minimum Salary
$70,000.00
Maximum Salary
$80,000.00
Compensation: $70,000-$80,000 per year
Remote: Yes
Apply Now