RN Denials Manager

Medasource is a leading consulting and professional services firm serving the healthcare industry, including Life Sciences, RCM/Payers, Technology, and Government. We’ve been recognized by both KLAS and Modern Healthcare for being good to our employees, consultants, clients, and communities. With over 100 clients, more than 2,000 active consultants, and over 30 locations across the U.S., we’re focused on propelling the future of healthcare, one client at a time.

RN Denials Manager Fully Remote Equipment Provided We are seeking an experienced RN Denials Manager to lead a centralized clinical denials review team for a large multi-state health system. This leader will oversee RN Denials/Audit Specialists responsible for reviewing medical necessity denials, coordinating appeals, and evaluating case documentation to support maximum reimbursement and high-quality patient care outcomes. This is a hands-on leadership role with direct oversight of team performance, operational workflow, payer-related escalation support, and staff development. Schedule: Monday–Friday, 8:00 AM–4:30 PM (AZ Time) No weekends, call, or holiday rotation

Lead daily operations of clinical denials review team; manage workflow and queue assignments Review medical necessity denials and support clinical appeal documentation Collaborate closely with Utilization Review, Case Management, and Physician Advisors Act as clinical subject matter expert for denial resolutions and case review standards Coach, develop, and mentor direct reports; support growth, training, and onboarding Monitor trends, identify payer patterns, and recommend process improvements Ensure compliance with internal review policies and payer requirement