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Job Description In the Assistant Director (RN) role, you will serve as clinical support and backup to the Director for all independent external appeals activities. You will assist with management of day-to-day operations of all client products, including administrative denials, medical necessity review, claims reviews, and DRG review. The Assistant Director (RN) will provide training and development for review activities to internal staff. Duties include but are not limited to: • With Director supervision, responsible for overseeing and tracking compliance with various health care rules, jurisdictional laws/regulations, and contract requirements. Audits compliance and responds to any detected risks or problems and, with Director input, determines appropriate action to prevent any recurrence of issues., • Direct supervisory staff including clinical, nurses, coders, and support staff performing review activities. Participate in negotiations with providers, as necessary. Respond to clinical and procedural questions and coordinate any revisions of Departmental processes and procedures., • Assist in oversight of operations, including report production. Manage the implementation of technical changes to review programs based on client needs and regulatory changes., • Responsible for maintaining the network of nurse and physician reviewers. Monitor timing and savings, as well as oversee the quality of the product(s)., • Train staff and monitor their performance., • Provide backup and coverage for the Director with Assistant VP assistance., • Assist with new product development, marketing, and business development. Qualifications: • Excellent interpersonal skills., • Highly organized with strong time management skills., • Excellent communication skills (written and verbal) with the proven ability to successfully direct both professional and support staff and work with governmental agencies, providers and clients., • Excellent supervisory/management skills with the ability to set work schedules, identify problems and formulate solutions., • Familiarity with computer system support to assure client satisfaction., • New York Licensed Registered Nurse and a graduate of an approved registered, professional nurses’ training program, required., • A bachelor’s degree in nursing or related discipline, required. The salary range and/or hourly rate listed does not include other forms of compensation or benefits. IPRO is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or military status.