Training Quality Manager (PHRN/USRN)
Gratitude IncTraining Quality Manager (PHRN/USRN)
Job Description
Key Skills
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QUALIFICATIONS:
• Bachelor’s Degree in Nursing with an active and valid license (PHRN/USRN)
• At least 2 years of experience in Utilization Management and medical necessity approval and denials
• Must have at least 1 or 2 years in a managerial position handling leaders/ TLs/ Supervisors
• With experience in training and quality management, preferably 5 years (Minimum 2 years required)
• Experience in a hospital setting or other clinical environment, such as BPO/CPO
• Familiarity with Medicare rules & regulations and guidelines, including coverage criteria and coding principles
• Experience in handling appeals, utilization review, or related healthcare management functions
• Excellent verbal and written communication skills are essential for preparing appeal arguments and communicating with different stakeholders
• Ability to analyze complex medical information and identify relevant clinical issues
• Have knowledge and experience in InterQual, NCQA and CMS.
• Willingness to work on-site with flexible schedules, including US hours and holidays
• Must not be a current or former employee of Concentrix
Role
Training Manager
Timings
Night Shift (Permanent)
Industry
BPO
Work Mode
Work from office
Process
Voice
Functional Area
ITES / BPO / Customer Service
Note: Myglit doesn't charge any money from candidates. If you have been asked to pay money to get this job then report to us immediately at support@myglit.com.
Interview Tips
- Giving the VNA round?
- What are the most important skills you acquired as a Soft Skills/VNA trainer?
- How would you handle an irate customer?
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