Director of Review Operations

New York City, New York
Aug 11, 2017
Sep 11, 2017
Contract Type
Full Time

Director of Review Operations

Healthcare agency, located in New York City, is seeking an individual for this full time position in the Review Operations Department. Reporting to the Executive Vice President.  

Responsibilities will include: directing and coordinating the daily operations
of all Retrospective accounts, Cost Outlier unit and the QARR/ HEDIS
department; Coordinates the planning, developing of all policies/procedures
pertaining to the programs to insure compliance to all local, State, and
Federal regulations and to meet the goals; Supervises QA activities with the Medical Director or designee in regards to RN and physician consultants; Works closely with administrative staff, MIS, IT and other departments; Monitor and evaluate performance of Program Managers and RNs.

Requirements include: Current NYS RN license and registration, Masters in healthcare studies or related field; 5 years progressive supervisory / management experience in a hospital or healthcare related organization and 3-5 years UR experience. Excellent written/verbal communication, computer organizational skills a must. In addition, you should be detail oriented have a commitment to continuously provide quality services to all customers.

We offer a comprehensive salary and group health, dental, life insurance, PTO time and retirement account. Please send resume to:  An EOE M/F/D/V.


To apply for this position, please email your resume and cover letter to:

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