PHRN Team Lead

We are looking for a
PHRN Team Lead
to oversee and support a team of Utilization Review Nurses in providing high-quality medical necessity reviews for our U.S. healthcare clients.

This leadership role requires strong clinical knowledge, hands-on UR experience, and the ability to guide and motivate a team in a fast-paced, remote work environment.

Key Responsibilities:

• Supervise and mentor a team of PHRN Utilization Review Nurses.
• Monitor team productivity, quality, and compliance with client and regulatory guidelines
• Assist in conducting pre-service, concurrent, and post-service medical necessity reviews as needed.
• Ensure accurate and timely completion of utilization reviews using MCG, InterQual, or client-specific criteria.
• Serve as the first point of escalation for clinical and operational issues.
• Coordinate daily workflow, assign tasks, and ensure adequate staffing coverage.
• Review audit findings...