Teams at NaphCare

Leads and evaluates clinical nursing operations for a correctional healthcare program. Responsibilities include nursing staff development, education, practice management, regulatory and contract compliance, and ensuring quality, evidence-based patient care. The role collaborates with the Health Services Administrator and requires an unrestricted Wyoming RN license, CPR certification, and 3–5 years of progressive healthcare management experience.

Reviews medical procedure and appointment authorizations, reconciles outstanding claims, enters vendor and provider data, and liaises between scheduling and claims teams. Maintains accuracy and confidentiality while processing high volumes of medical records and claim information, meeting deadlines, and supporting timely claim resolution.

Manages claims review specialists and oversees timely, accurate processing of medical authorizations and claims. Reviews healthcare authorizations, reconciles outstanding claims, monitors team performance, prepares analytics reports, maintains confidential medical records, and improves operational workflows. Requires healthcare claims, billing, or medical authorization experience, strong organizational skills, and proficiency with Microsoft Excel.