Startups

Manager, Complex Clinical Review

Machinify · Remote - US · Remote

← All jobs
About Machinify

Backed by Battery and GV.

About the role

The ideal candidate leverages their nursing background, deep knowledge of clinical review, and experience leading others to manage staff and operational results for a remote team of nurses and other audit roles, performing clinical review audits.

What they're looking for

  • Current, unrestricted nursing license in good standing is required - certified coding certification is a plus
  • 3+ years relevant supervisory or leadership experience in similar business environment, preferred. Experience managing remote staff is a plus
  • 3+ years’ experience performing clinical audits of itemized bills
  • 3+ years’ diverse nursing experience providing direct care in an inpatient or outpatient setting
  • Proven experience with healthcare industry software products and process development
  • Experience managing multiple projects in a team environment
More about this role

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We’re constantly reimagining what’s possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.

The ideal candidate leverages their nursing background, deep knowledge of clinical review, and experience leading others to manage staff and operational results for a remote team of nurses and other audit roles, performing clinical review audits. The Manager will leverage first-hand experience and knowledge of claims auditing for supporting management with strategy activities such as needs assessments, capacity planning, and ensuring required staffing levels and productivity & quality standards are being achieved consistently.

  • Oversee the Complex Clinical Bill Review team, managing...

Read the full posting on Machinify's site ↗

Clinical & Coding Auditors

Build your edge while you search

Free tools for founders and investors, plus VC Unfiltered, our take on startups, venture and the people who build them.