Clinical Operations Manager (RN, NP, PA, or DO)

Company Overview:

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Job Summary and Responsibilities:

Acentra Health is looking for a Clinical Operations Manager (RN, NP, PA, or DO) to join our growing team.

Job Summary:

Manages the day-to-day operations for the Clinical Operations, Utilization Management, and/or Clinical Reviewers, assuring quality customer service and support for clients and staff, including developing and enforcing operational policies and procedures, managing staff, monitoring, and managing correspondence between external stakeholders and the company, and operational status reporting to leadership.

 

*This position is hybrid, with most work conducted remotely. However, occasional travel up to 15 percent is expected for in-person meetings at the Portland office and to attend conferences throughout the state.

Responsibilities:

• Coordinates and directs clinical operations and related programs and directly supervises clinical support staff.
• Coordinates special programs such as automated outreach system and incentive plans.
• Develops and maintains procedures and practices for accomplishing departmental or program goals and objectives.
• Develops and monitors business and financial metrics related to the day-to-day operational success of the program; reports and measures progress toward operational goals through periodic reviews.
• Coordinates all aspects of clinical operations including program coordination, scheduling, work plan management, status reporting and issue resolution tracking.
• Assumes responsibilities for the Director, Operations in his/her absence.
• Resolves program or department operations issues or delegates to the appropriate personnel or staff members for prompt resolution.
• Supervises and manages the day-to-day activities of the assigned case management and utilization review teams, including interdisciplinary team integration and field-based services.
• Mentoring, coaching, and training team members for all clinical processes to ensure quality and contract deliverables are met.
• Supporting the interdisciplinary team with the underlying objectives of maximizing enrollment, enhancing the quality of clinical outcomes (including participant satisfaction), ensuring contractual, regulatory, and accreditation compliance, and providing timely and accurate data and communications.
• Effectively manages team assignments, evaluating and addressing workload to align with departmental demands and contractual obligations. Adjusts staff assignments and tasks to enhance member-related results and client satisfaction.
• Performs quality monitoring activities, including identifying areas for improvement for individual team members, processes, and quality improvement initiatives.
• Ensures compliance with regulatory and accreditation (URAC) standards and contractual service level agreements.
• Participates in developing, implementing, evaluating, and revising clinical pathways/assessments and care plans, and other case management tools that specifically support case management programs.
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

The above list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.

Qualifications:

Required Qualifications

• Requires a minimum of a bachelor’s degree in a health-related field and 10+ years of clinical experience

• Active, unrestricted, and unencumbered Registered Nurse (RN), Nurse Practitioner (NP), Physician's Assistant (PA), or Doctor of Osteopathic Medicine (DO) licensure in Oregon AND the ability to obtain a Nebraska RN, NP, PA, or DO state license within 3 months of your start date, if selected

• 3+ years of recent management experience
• Public and private sector healthcare experience and/or has been involved in providing services to government or commercial programs
• 3+ years of case management and utilization review (UR) (e.g., Utilization Review, Clinical Review, or Prior Authorization)experience
• Ability to work within the company’s decision-making and organizational structure
• Skill in examining and re-examining operations and procedures, formulating policy, and developing and implementing new strategies and procedures
• Knowledge of U.S. healthcare industry; preferably with experience in both public and private sector
• Expertise in employee development and performance management skills
• Ability to analyze resources and environment appropriate to the scope of responsibility and design a course of action consistent with the company’s mission and strategic plan
• Demonstrated achievement in P&L management, operational process engineering, remote operations management, and new business development support

Preferred Qualifications

• Ability to successfully manage change and growth
• Knowledge of business development, strategic planning, tactical implementation, and creation of business partnerships
• Demonstrated expertise in managing differing customer needs
• Ability to participate as a team member fostering collaborative decision-making among leadership, committees, teams, or work groups of diverse composition

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

Thank You!

We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

EEO AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

Compensation

The pay for this position is listed below.

"Based on our compensation philosophy, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level."

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Pay Range: USD $72,768.00 - USD $113,700.00 /Yr.