Job Description
Job Description
This Supervisor position is for the Medicare member/non contracted provider appeals team. The Supervisor will lead a professional team of Medicare appeals nurse consultants to be best in class and coach and support appeals nurses to excel. The Supervisor is responsible for oversight of healthcare management staff including the organization and development of high performing teams. Works closely with functional area managers, dedicated appeals team Medical Directors and clinical team leads to ensure consistency in clinical interventions supporting our members. Accountable for meeting the financial, operational and quality objectives of the unit.
The Medicare member/non-contracted provider appeals team team operates 7 days per week, 365 days per year. Position requires working some weekends and holidays on a scheduled rotation.
Required Qualifications
Registered Nurse with current unrestricted state licensure
5-7 years acute care clinical experience
Preferred Qualifications
3-5 years of utilization review experience
3-5 years of Medicare appeals experience
Education
Associate's Degree (required)
Bachelor's Degree (preferred)
Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
This Supervisor position is for the Medicare member/non contracted provider appeals team. The Supervisor will lead a professional team of Medicare appeals nurse consultants to be best in class and coach and support appeals nurses to excel. The Supervisor is responsible for oversight of healthcare management staff including the organization and development of high performing teams. Works closely with functional area managers, dedicated appeals team Medical Directors and clinical team leads to ensure consistency in clinical interventions supporting our members. Accountable for meeting the financial, operational and quality objectives of the unit.
The Medicare member/non-contracted provider appeals team team operates 7 days per week, 365 days per year. Position requires working some weekends and holidays on a scheduled rotation.
Required Qualifications
Registered Nurse with current unrestricted state licensure
5-7 years acute care clinical experience
Preferred Qualifications
3-5 years of utilization review experience
3-5 years of Medicare appeals experience
Education
Associate's Degree (required)
Bachelor's Degree (preferred)
Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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