US Healthcare Clinical Lead (RN)

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