Supervisor, Medical Review - Clinical

Deep Roots. Solid Growth. Caring People. Rooted in Wyoming! We are bolthires Wyoming: a not-for-profit health insurer with offices throughout the state. Ever since a small group of caring, persistent Wyoming women helped us put down roots in 1945, everything we do is aimed at better health care for the people of Wyoming. Our Vision: We envision a future where integrity, compassion, and trust define a local health insurance experience. Committed to doing the right thing for our members, employees, and community, we strive to protect and contribute to the health and care of all we serve.Our Mission: provide our members with access to local health insurance solutions that prioritize health, care, and well-being for those who call Wyoming home. If our passion and purpose resonate with you, you may be who we are looking for. The role we are looking to fill:Supervisor, Medical Review - ClinicalAs a Clinical Supervisor, you will serve as a key leader within the Medical Review Department at BCBSWY, playing a pivotal role in enhancing the healthcare experience for members and strengthening relationships within the provider community.This position empowers the clinical team and collaborates closely with non-clinical staff to uphold organizational standards for quality and timeliness. In this role, you will have operational oversight and be responsible for training and monitoring assigned staff in the performance of their duties. This will include all aspects of supervisory activities such as scheduling, payroll, counseling, coaching, reviewing and other related functions. Being a part of the bigger BCBSWY Team, you will collaborate with other departments within the organization on both clinical and non-clinical issues to drive process improvement initiatives and enhance workflow.To be successful in this role, you will need to have the ability to lead people utilizing effective communication, interpersonal, organizational, and motivational skills. Minimum qualifications include an earned Associate of Science degree of RN or higher, an active and unrestricted license to perform clinical functions and at least two years of supervisory experience, preferably in medical management or a health-related field. As a recognized BCBSWY employee, we count on you to positively serve in the role of "Brand Ambassador" within the local community and/or geographical region.To your friends and neighbors - you ARE bolthires Wyoming! BCBSWY Employees Enjoy:Best-In-Class Health Insurance at minimal to no-bolthires for BCBSWY employees! PLUS many other benefits along with highly competitive compensation! Our compensation program is reviewed for competitive market match on an annual basis and employees are eligible for annual merit increases. Monthly incentives that are based on individual and company performance are also available to eligible employees and members of our Sales Team can realize generous performance-based commissions.At BCBSWY our employees are provided best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include medical, dental, vision, 401(k), life insurance, paid time off (PTO), 10 paid holidays in addition to PTO annually, plus 8 paid volunteer hours, various wellness programs, and a dress code of "Dress forYour Day!" which can mean jeans every day (depending on your role). Serving Those Who Call Wyoming Home. Our positions are all based in Wyoming. Depending on the department and the position, eligible employees may be offered limited In-Office/WFH flexibility (for those positions that are offered limited WFH, there will be a required number of In-Office days per week/month depending on department).Executive level employees are required to reside full-time in Wyoming. Our Selection Process:Typically includes the following (NOTE: process steps may differ depending on role applied for)• Review of your completed application and any additional submitted materials (e.g., cover letter, certifications, etc.) for minimum qualifications and skills alignment. • Confirmation of Wyoming residency, intent to become a Wyoming resident, or reasonable commuter distance if Colorado resident. • Recruiter Phone Screen.• Possible Self-Assessment and/or Questionnaire. • Initial interview with Hiring Manager. • Possible 2nd Interview with Hiring Manager and/or additional Team members. • Comprehensive Background Check. BCBSWY is an Equal Opportunity Employer. We do not discriminate based on race, color, religion, national origin, sex, age, disability, genetic information, or any other status protected by law or regulation. Qualified applicants are provided with an equal opportunity and selection decisions are based on job-related factors.We use E-Verify to confirm employment eligibility; we DO NOT sponsor applicants for work visas. BCBSWY is committed to the full inclusion of all qualified individuals. As part of this commitment, we will ensure that persons with disabilities are provided reasonable accommodations for the application, selection, and hiring process. If reasonable accommodation is needed, please contact: [email protected] Apply tot his job