Active and unrestricted U.S. Registered Nurse (USRN) license.

• Minimum 2-3 years of clinical bedside experience, preferably in ER, ICU, Med-Surg, Telemetry, or acute care.
• Minimum 5 years leadership experience in U.S. Healthcare Clinical BPO operations (UM, CM, Appeals, Triage, etc.) managing Team and their collective output
• Strong understanding of MCG/Milliman, InterQual, CMS guidelines, HIPAA, and U.S. medical terminology.
• Background in client management, performance governance, and process optimization.
• Background in performance management, coaching, and operational analytics
• Excellent communication, stakeholder management, and strategic decision-making skills.
• Proficiency in operational dashboards, analytics, and reporting tools.

B. Preferred
• Experience managing multi-site or large-scale healthcare operations.
• Working knowledge of ICD/CPT coding, healthcare auditing, or clinical documentation improvement (CDI).
• Certifications in leadership, project management, or healthcare quality are an advantage.