Supervisor - State Arbitration

Description & Requirements

Maximus is currently hiring for a Supervisor to join our State Arbitration team.

This is a remote opportunity.

The Supervisor is responsible for overseeing and managing the staff involved in the IDRE program.

Additionally, they will be responsible for performing stability checks and back-end quality review.

Essential Duties and Responsibilities:

- Provide supervision and clinical oversight to team of direct reports.

- Discuss job performance concerns with direct reports to identify causes and issues and work closely with the HR department on resolving problems.

- Conduct case reviews and consultations as needed; identify need for escalation to management, physician or related disciplines

- Serve as subject matter expert on area of clinical knowledge including training and education

- On contract requiring assessments, may conduct assessments or field training of assessors as needed

- Instruct, demonstrate, observe skills and techniques of nursing staff and provide feedback to management.

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- May attend client and stakeholder meetings

- Performs other related duties as assigned.

Required Skills/Abilities:

- Subject Matter knowledge in area of contract operations

- Ability to identify and prioritize tasks based on level of time sensitivity and/or potential health and safety concerns

- Supervise and manage the staff involved in the IDRE program.
- Ensure that all dispute cases are reviewed and processed in a timely and accurate manner.
- Collaborate with healthcare providers, health plans, and other stakeholders to facilitate the resolution of disputes.
- Maintain detailed records of all cases and ensure compliance with HIPAA and other regulatory requirements.
- Monitor and evaluate the performance of staff, providing feedback and coaching as needed.
- Stay informed about current trends and best practices in healthcare billing and dispute resolution.

Minimum Requirements

- Current Registered Nurse (RN) license valid in the state of practice is required-

-Bachelor's degree preferred, High School Degree or equivalent required

- Minimum of 2 years of nursing experience.

- Prior experience with clinical supervision or as a charge nurse preferred.

- Experience in healthcare billing, coding, or dispute resolution is highly preferred.

- Nursing experience in an ICU or ER setting preferred.

- Ability to commit to a training schedule between the hours of 8:00am - 5:00pm EST Monday - Friday required.

- Excellent communication and interpersonal skills.

- Ability to work independently and make informed decisions.

- Detail-oriented with strong organizational skills.

- Strong problem-solving skills and ability to handle high-pressure situations.

Please note: For this position Maximus will provide equipment to use.

Home Office Requirements:
- Internet speed of 20mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
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