• Supervise, mentor, and develop a team of Clinical Appeals and Denials RNs. • Conduct regular coaching sessions, performance reviews, and professional development planning. • Monitor productivity, quality, and compliance metrics to ensure achievement of departmental goals. • Facilitate team meetings, training sessions, and ongoing education initiatives. • Manage staffing assignments, workload balancing, PTO coverage, and scheduling needs. • Oversee the review and management of medical necessity, authorization, and clinical validation denials. • Ensure timely preparation and submission of first-level, second-level, and external appeals. • Guide staff in developing evidence-based appeal arguments utilizing clinical documentation, regulatory requirements, and nationally recognized guidelines such as InterQual and MCG. • Review complex and high-dollar denials and provide escalation support as needed. • Ensure all appeals meet payer-specific requirements and submission deadlines. • Analyze denial trends and identify root causes impacting reimbursement. • Collaborate with Revenue Cycle, Case Management, Utilization Review, CDI, HIM, and Operational Leadership to implement denial prevention strategies. • Monitor recoveries, overturn rates, appeal success metrics, and financial outcomes. • Develop action plans to address payer performance concerns and recurring denial patterns. • Participate in client and leadership meetings to present denials performance and recommendations. • Ensure adherence to organizational policies, regulatory requirements, and payer guidelines. • Perform quality audits of appeal submissions and provide feedback to staff. • Maintain expertise in CMS regulations, Medicare and Medicaid requirements, commercial payer policies, and industry best practices. • Support audit readiness and compliance initiatives. • Identify and implement process improvements that enhance efficiency, quality, and financial outcomes. • Assist in developing standard operating procedures, workflows, and training materials. • Utilize data analytics and reporting tools to monitor team effectiveness and operational performance. • Support implementation of new clients, programs, and denial management initiatives.

• Provide clinical consultation and mentorship to a panel of nurse practitioners with a combined capacity of up to 7.0 FTE. The panel may include more than seven individual providers, including a mix of W-2 employees and 1099 contractors, provided the total clinical capacity does not exceed 7.0 FTE. • Host a regular (weekly or biweekly) group case consultation session for the NP team to discuss complex or higher-acuity cases. • Provide physician collaboration and supervision for nurse practitioners with prescriptive authority, including timely review of prescribing practices and medical records as required by applicable state regulations, including oversight of Schedule II–V controlled substance prescribing. • Be available for ad hoc, asynchronous consultation on psychopharmacologic questions specific to reproductive psychiatry — e.g., medication management in pregnancy and lactation, postpartum depression and anxiety, perimenopausal and menopausal mood disorders, and bipolar disorder across reproductive transitions. • Support onboarding of new NPs with orientation to FamilyWell's reproductive psychiatry clinical protocols and best practices. • Contribute clinical expertise to the ongoing development and refinement of FamilyWell's clinical guidelines and protocols. • Participate as needed in FamilyWell's clinical quality and risk-management processes (e.g., case reviews following an adverse event or escalation).

• Provide clinical consultation and mentorship to a panel of nurse practitioners with a combined capacity of up to 7.0 FTE. • Host a regular (weekly or biweekly) group case consultation session for the NP team to discuss complex or higher-acuity cases. • Be available for ad hoc, asynchronous consultation on psychopharmacologic questions specific to reproductive psychiatry. • Support onboarding of new NPs with orientation to FamilyWell's reproductive psychiatry clinical protocols and best practices. • Contribute clinical expertise to the ongoing development and refinement of FamilyWell's clinical guidelines and protocols. • Participate as needed in FamilyWell's clinical quality and risk-management processes.

• Responsible for all clinical aspects of treatment for the patients they oversee • Develop and maintain treatment plans • Ensure that all supervision hours are at 100% treatment adherence each month • Evaluate patients to identify both skill deficits and strengths • Analyze challenging behaviors to identify the function of the behavior • Develop functionally relevant treatment plans • Observe treatment implementation for potential program revisions • Monitor treatment integrity to ensure satisfactory implementation of treatment protocols • Provide ongoing coaching and training to behavioral technicians • Summarize and analyze data to evaluate patient progress towards treatment goals