Job Description Are you the right candidate for this opportunity Make sure to read the full description below.
Are you the type of Mental Health professional who is excited to guide and grow the next generation of clinicians? At Real Help, that isn't just a line - it is the heart of who we are.
Real Help is a premier, mission-driven mental health provider recognized for delivering high-quality, client-centered care entirely through telehealth services. We are seeking compassionate, independently licensed clinicians who are energized by leadership, mentorship, and clinical excellence.
What You'll Do:
The Clinical Supervisor will play a pivotal role in strengthening our remote clinical workforce by providing high-quality supervision and guidance to telehealth clinicians. You will help shape clinicians' skills, enhance their clinical decision-making, and promote consistent, strength-based therapeutic practice in a fully virtual setting.
You will be responsible for:
• Providing weekly clinical supervision to telehealth clinicians
• Supporting clinical growth, reflective practice, and skill development
• Reviewing assessments, treatment plans, and documentation
• Offering consultation to clinicians on challenging cases
• Ensuring all services meet Real Help standards and ethical guidelines
• Collaborating with leadership to maintain a positive, learning-centered environment
What We're Looking For:
• Independent state licensure: New York required. Licensed Clinical Social Worker (LCSW) or LMHC with diagnostic privilege.
• Master's Degree in Social Work
• Minimum 2 years of experience supervising clinicians
• Strong foundation in evidence-based practices and strength-based care
• Excellent communication, organization, and leadership skills
• A genuine passion for developing clinicians and elevating the quality of care across telehealth services
Why Join Real Help? xevrcyc
• Work remotely while influencing the next generation of mental health providers
• Supportive leadership invested in your success
• Flexible scheduling and Fee-For-Service compensation
• A growing, respected organization that values empathy, excellence, and innovation
Compensation:
•$60 - $65/ hr
If you're an independently licensed professional eager to make a meaningful impact, we can't wait to meet YOU! Apply today and help us continue building a telehealth team that clinicians are proud to grow within.
$60-65 hourly 2d ago
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Remote Board-Certified Genetics Lab Director (Sign-Out & QA)
Quest Diagnostics 4.4
Remote job
A leading diagnostics company is seeking a Board Certified Sign Out Director of Genetics. Responsible for interpretation of molecular genetic assays and implementing new assays. Candidates must have California Clinical Genetics Molecular Certification and a strong background in NGS. This role allows for remote work, making it a versatile option for qualified candidates. Join a vibrant team dedicated to quality assurance in genetic testing and contribute your expertise in a dynamic environment.
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$101k-133k yearly est. 5d ago
Prior Authorization Medical Director Physician- Los Angeles, CA Area - Work From Home
Curative 4.0
Remote job
Prior Authorization Medical Director Physician Opportunity in the Los Angeles Area
Please consider this unique opportunity to join a well-established and respected group of innovators in value-based care. This group of thought-leaders are in search of physician leaders to work alongside them to move the organization forward.
Requirements
MD/DO degree required
Remote position, but candidate must live in the greater L.A. area for onsite meetings.
Minimum of five years of prior clinical experience required, with at least two years of managed-care or health-plan experience preferred
About the Opportunity
Understand, promote, and manage the principles of medical management to facilitate the right care for patients at the right time and in the right setting.
Review prior authorization requests for medical necessity using appropriate clinical guidelines.
Identify high-risk patients and help coordinate care with the Employer's high-risk team.
Participate in meetings to review, develop, and continually improve internal quality improvement and peer review processes and programs.
Perform prior authorization functions for various Employer campuses, should the need arise in cross coverage, secondary/tertiary review, or medical director decision-making.
Perform retroactive claims review for outpatient and inpatient care, as needed.
Compensation and Benefits
Competitive salary and aggressive incentives
Comprehensive benefits including medical, dental, vision, and 401k
Sign on bonus
Ample paid time off
About the Area
Live in the entertainment capital of he world and enjoy dynamic mix of amenities that include outdoor adventures, fine dining, theme parks, the arts, world-class sports teams, and access to a major international airport
Unmatched cultural amenities in one of the most diverse areas of the world
Excellent public and private schooling options as highly respected colleges and universities
World-class beaches and mountain resorts are within a short drive
Enjoy a warm climate with over 300 sunny days a year
$174k-266k yearly est. 3d ago
Clinical Supervisor, BCBA - Up to 10K Sign on Bonus
Accel Therapies
Remote job
Clinical Supervisor (BCBA) Total Earnings Potential: $96,000 - $111,000 in your first year Includes: Base salary of $80,000-$95,000 Up to $6,000 in annual performance bonuses (paid monthly) Sign-on bonus of up to $10,000 Schedule: Monday-Friday, 8:00 AM - 5:00 PM- so you can enjoy evenings at home!
Work Setting: Center-based
Work From Home:
2
WFH days per week (with eligibility)
Other Perks
Medical, dental, and vision insurance
(2 weeks) Paid time off and 8 paid holidays
$750+ annual CEU reimbursement for professional development
401(k) with up to 4% match (vested after 1 year)
Frequent team events, social lunches, and a positive center culture
Expanding company offering long-term career growth potential
Involvement in innovative research initiatives and academic collaborations, including work with UCLA
About the Role
Accel Therapies is hiring Board Certified Behavior Analysts (BCBAs) who are passionate about clinical excellence and being part of a collaborative, supportive team. As a Clinical Supervisor, you'll join an organization that prioritizes your growth and impact by reducing administrative burdens and allowing you to focus on what matters most - delivering high-quality clinical care.
Our service model may vary by location, but across all sites, you'll be supported by a team structure that promotes collaboration, development, and strong clinical outcomes.
What You'll Do
Lead functional assessments and develop data-driven treatment plans
Provide mentorship and supervision to BTs and Program Supervisors
Deliver parent training and ensure high clinical quality
Maintain 30 billable hours per week
Collaborate within a pod model to support peers and promote clinical consistency
Contribute to ongoing training, QA, and curriculum development
What You Bring
Master's degree in Applied Behavior Analysis or related field
Current BCBA certification
Experience working with individuals with autism and developmental needs
Comfortable using technology (iPad, electronic data collection, scheduling platforms)
TB test, immunization records, and background check clearance
Spanish-speaking is a plus
Why Accel Therapies
Our BCBAs are supported, not stretched thin. You'll know what each day looks like, work with a team that values open communication and collaboration, and focus solely on clinical care. We provide mentorship, ongoing professional development, and a pathway for career growth - all within a culture that's structured, empowering, and team-oriented.
Apply today and join a company that puts its clinicians first.
#AT3PandoLogic. Category:Healthcare, Keywords:Clinical Supervisor, Location:Boise, ID-83725
$96k-111k yearly 1d ago
Clinical Program Manager
Histosonics 3.6
Remote job
HistoSonics is a medical device company, founded in 2009, that has developed a non-invasive, sonic beam therapy platform that uses histotripsy, which is capable of destroying targeted liver tumors. Our mission and passion are to advance the novel science of histotripsy and its powerful benefits, bringing meaningful and transformational change to physicians and their patients.
Location: Remote position, ideally candidates will live in a major metro area with an international airport.
Travel Expectation: Travel (by automobile or air, day trips and overnight stays) up to 25% of the time.
Position Summary:
The Clinical Program Manager (Clinical PM) develops, manages and executes global clinical studies in collaboration with the Clinical Affairs team in accordance with applicable regulatory requirements and company's strategic imperatives. The Clinical PM manages all activities of study design and development, vendor management, site management including qualification, training, activation and monitoring. The Clinical PM will ensure study performance and compliance.
Key Responsibilities:
* Responsible for the management of Clinical Trials from inception through Clinical Study Report (CSR) completion.
* Ensure clinical trial activities are completed on time, within budget and in a highly dynamic and complex environment in accordance with appropriate quality standards including ICH/GCP requirements.
* Create and implement study-specific clinical monitoring tools and documents.
* Lead the identification, evaluation, selection, and oversight of clinical trial sites.
* Author and implement operational plans to ensure efficient study enrollment and monitoring activities at clinical sites.
* Review/approve vendor and site invoices and track study budget to forecast, working closely with finance and clinical business operations.
* Responsible for implementation and oversight of Trial Master File for inspection readiness.
* Drive overall process and provide support to cross-functional teams in the development of study documents including study protocols, consent forms and budget templates.
* Serve as lead in the creation of project plans, logs, templates, newsletters, and other documents.
* Review and approve site specific documents (such as informed consent forms, site budgets, monitoring reports).
* Provide study updates and reports, inclusive of study risks and issues.
* Lead internal and external meetings, including Investigator Meetings, conferences, events and study management meetings.
* Responsible for ongoing study data reviews and data cleaning activities.
* Provide oversight of study activities such as site initiation, data quality, interim monitoring and close out activities.
* Support the development of study training to investigators, site staff and internal staff.
* Participate in the preparation and follow up of internal process audits, vendor, and study site quality audits as well as regulatory inspections.
* Other duties as assigned.
Qualifications and Skills:
* Bachelor's degree in relevant area of study.
* Minimum of 2-3 years clinical trial management experience; IDE trial experience preferred.
* Minimum of 5 years experience in the medical device industry REQUIRED.
* Knowledge of, and experience with, the FDA and the EU regulatory environments.
* Excellent written and verbal communication skills.
HistoSonics will not offer sponsorship or take over sponsorship of an employment visa for this position at this time.
Benefits: We offer a comprehensive benefits package for full-time employees. This includes health, dental, and vision insurance, life, short-term and long-term disability insurance, 401(k), paid time off, and more.
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
#LI-Remote
$68k-107k yearly est. 60d+ ago
Program Manager, Clinical Insights
Wellsense Health Plan
Remote job
It's an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.
Job Summary:
The Program Manager, Clinical Insights is responsible for implementing and managing programs designed to improve health outcomes and strengthen financial performance overall and at the product level. Program coordination will take place across multiple clinical stakeholder groups such as care management, utilization management, and quality teams.
The Program Manager, Clinical Insights supports programs and clinical best practices with the objective of improving health outcomes, preventing hospital readmissions, improving member safety and reducing medical errors, and promoting health and wellness activities, where appropriate. The position may engage in functions of health information technology development that enhances or maintains activities associated with QI initiatives, accreditation, and monitoring, measuring or reporting clinical effectiveness and outcomes.
Our Investment in You:
· Full-time remote work
· Competitive salaries
· Excellent benefits
Key Functions/Responsibilities:
· Implement and manage member health promotion programs associated with NCQA Population Health Management standards, and general member health and wellness programs designed to improve health outcomes and reduce inappropriate utilization, including pilots and new program design interventions
· Lead performance improvement projects associated with annual Performance Improvement budget and corporate goals, assembling stakeholders to design, execute, and monitor projects
· Manage and drive execution on outbound campaigns and selective member outreach, partnering with Care Management teams and Quality
· Key point of contact to engage with marketing on overall clinical, member facing information
· Support centralization of active member outreach by various teams
· Support program monitoring through the use of analytic dashboards and KPIs
Supervision Exercised:
· None
Supervision Received:
· General supervision is received weekly.
Qualifications:
Education:
· Bachelor's degree or equivalent combination of education and relevant experience in a health plan setting required
Education Preferred/Desirable:
· Master's degree in business or health related/public health field preferred
Experience:
· 3+ years of healthcare/managed care experience
· 3+ years in program management, healthcare operations, or other applicable work experience
· Managed care experience in NCQA accreditation, care management, population health, or quality programs
Certification or Conditions of Employment:
· Successful completion of pre-employment background check
Competencies, Skills, and Attributes:
· Exceptional written and oral communication skills.
· Excellent organizational skills and attention to detail
· Demonstrated ability to work independently and manage multiple complex projects simultaneously
· Proactive, motivated, and a collaborative team player
· Demonstrated ability to adapt quickly to changing priorities
· Strong critical thinking, analytical, and problem-solving skills
· Proficiency with MS tools including Word, Excel, PowerPoint, Visio and MS Project
· Demonstrated ability of managing competing priorities as well as stakeholders with differing objectives/perspectives.
Working Conditions and Physical Effort:
· Able to perform all work from a remote environment
· Occasional travel may be required
· Regular and reliable attendance is an essential function of the position
Compensation Range
$69,500 - $100,500
This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensure as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, WellSense offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family wellbeing.
Note: This range is based on Boston-area data, and is subject to modification based on geographic location.
About WellSense
WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members.
Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees
$69.5k-100.5k yearly 10d ago
Clinical Program Manager - CMS Medical Review (RVC)
Broadway Ventures 4.2
Remote job
At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth. Built on integrity, collaboration, and excellence, we're more than a service provider-we're your trusted partner in innovation.
Location: Remote (U.S.)
Schedule: Monday-Friday, 8:00 AM-4:30 PM ET
Employment Type: Full-Time
Position Overview
We are seeking an experienced Program Manager to oversee daily operations for the CMS Review and Validation Contractor (RVC) Program. This role serves as the primary point of contact to the CMS RVC COR and is responsible for ensuring all contract, operational, and medical review requirements are executed in accordance with CMS guidelines.
The ideal candidate brings a strong clinical background (RN), extensive Medicare program knowledge, and proven leadership experience managing large, complex healthcare projects.
Key Responsibilities
Serve as the contractor's authorized representative on all daily operational matters.
Maintain ongoing communication with the CMS RVC COR regarding contract performance, staffing, and deliverables.
Oversee medical review activities and ensure compliance with CMS guidelines and FFS RAC Program requirements.
Lead cross-functional teams and manage staff required to support RVC operations.
Ensure accurate interpretation of Medicare coverage, documentation, and regulatory standards.
Monitor project progress, performance measures, and quality assurance outputs.
Prepare operational updates, reports, and data summaries for CMS and internal leadership.
Ensure effective workflows, staffing coverage, and adherence to deadlines and contract terms.
Provide clinical oversight and guidance across medical review tasks and methodologies.
Required Qualifications
5+ years of Program Management experience overseeing large or complex healthcare projects.
Experience in medical review, healthcare auditing, or clinical review operations.
Extensive knowledge of the Medicare program, including CMS regulatory and operational requirements.
Working knowledge of the CMS FFS RAC Program.
Strong leadership abilities with experience managing multidisciplinary teams.
Education & Licensure
Master's degree in Business, Healthcare Administration, Nursing, Management, or a related healthcare field from an accredited institution.
Current, active U.S. Nursing License (RN); must be maintained throughout employment.
Preferred Skills
Excellent written and verbal communication skills.
Strong analytical, organizational, and problem-solving abilities.
Experience working with government contracts or federal healthcare programs.
Ability to manage multiple projects and deadlines in a fast-paced environment.
Why Join Us
Opportunity to lead mission-critical work that supports the integrity of the Medicare program.
Collaborative team environment with impactful clinical and operational responsibilities.
Competitive compensation and benefits package.
How to Apply
Submit your resume detailing your program management experience, clinical background, and Medicare/CMS expertise.
What to Expect Next:
After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and discuss salary requirements. Management will be conducting interviews with the most qualified candidates. We perform a background and drug test prior to the start of every new hires' employment. In addition, some positions may also require fingerprinting.
Broadway Ventures is an equal-opportunity employer and a VEVRAA Federal Contractor committed to providing a workplace free from harassment and discrimination. We celebrate the unique differences of our employees because they drive curiosity, innovation, and the success of our business. We do not discriminate based on military status, race, religion, color, national origin, gender, age, marital status, veteran status, disability, or any other status protected by the laws or regulations in the locations where we operate. Accommodations are available for applicants with disabilities.
$62k-96k yearly est. Auto-Apply 51d ago
Clinical Program Manager, HSPRS
Equal Opportunity Employer: IRC
Remote job
The International Rescue Committee (IRC) responds to the world's worst humanitarian crises, helping to restore health, safety, education, economic wellbeing, and power to people devastated by conflict and disaster. Founded in 1933 at the call of Albert Einstein, the IRC is one of the world's largest international humanitarian non-governmental organizations (INGO), at work in more than 40 countries and 29 U.S. cities helping people to survive, reclaim control of their future and strengthen their communities. A force for humanity, IRC employees deliver lasting impact by restoring safety, dignity and hope to millions. If you're a solutions-driven, passionate change-maker, come join us in positively impacting the lives of millions of people world-wide for a better future.
The IRC's Home Study and Post-Release Services (HSPRS) for unaccompanied children in the U.S. is a national, multi-million-dollar project with ambitious delivery goals in a short time frame.
The goals of the Home-Study Post Release Services Program (HS/PRS) are to:
- Assess the safety and suitability of a sponsor before an unaccompanied child is released from custody into a sponsor's care (Home Study)
- Provide case management support via remote and / or conducting in-home visits to ensure the continued safety and stability of children in sponsor's homes and linking children to resources in the community (Post Release Services).
The HSPRS Clinical Program Manager (CPM) provides a combination of capacity building, staff supervision, and supervision of complex cases to IRC's Home Study and Post-Release Services (HSPRS) programming, as well as provides support to other emergent issues related to Unaccompanied Children's protection in the U.S. This role provides clinical supervision to between four and eight Master Level intensive case managers who are providing case management services to Unaccompanied Children enrolled in HSPRS services throughout the United States. The CPM will help ensure that services and supports that are delivered to unaccompanied minors in HSPRS services are done in alignment with trauma-informed and developmentally appropriate best practices. The position will act as a point of escalation for complex or crisis cases and provide coaching and consultation to help ensure that they are resolved with the safest possible outcomes. The CPM is also expected to advance frameworks, guidance, training materials, manuals and other resources in alignment with federal, state, local and donor requirements and IRC global guidelines.
Major Responsibilities:
• Supervise 4-8 Masters-level case managers that provide direct services to highly vulnerable unaccompanied children.
• Help support onboarding and provide regular training and other professional development opportunities in critical competencies like child development considerations, trauma informed care principles, crisis management, etc.
• Provide staff consultation and coaching to increase the capacity of staff to deliver trauma-informed, developmentally appropriate, and culturally responsive services while supporting staff in the management of cases that require expert level clinical skills.
• Support HSPRS staff in liaising with complex systems (i.e., child welfare, law enforcement, mental health, etc.).
• Assist HSPRS staff as needed in appropriate internal and external mental health and crisis intervention resources and provide oversight of crisis intervention and advise on clinical needs and related referrals.
• Provide point of escalation for clinical questions to ensure that services are ethical and aligned with best practices.
• Ensure that the IRC's HSPRS efforts align with established professional treatment standards and practices.
• Support staff in staying resilient by reinforcing positive work practices and self-care strategies, including facilitating connections to Duty of Care resources as appropriate.
• Provide direct input and support to local supervisors on the recruitment, onboarding, training and performance management of HSPRS Intensive Case Managers.
• Liaise regularly with direct supervisors of field-based HSPRS staff on program progress.
• Other duties as assigned.
Job Requirements:
• Must have a Masters degree in social work, psychology, sociology or other relevant behavioral science in which clinical experience is a program requirement, plus at least two years of post-graduate direct services experience, Clinical licensure preferred.
• Must have HSPRS experience.
• At least five years of experience managing complex cases with vulnerable populations, ideally with children and adolescents, within the context of foster care, guardianship, or kinship care.
• At least two years of experience working with refugee, immigrant, migrant or other forcibly displaced communities.
• Demonstrated experience supervising staff, interns or volunteers. Clinical supervisors must have prior supervisory experience and should be licensed to provide clinical supervision, so long as supervising PRS conducted across state lines does not violate state licensing rules.
• Strong understanding of child development, trauma-informed care, responsive service delivery, and strength-based and client-centered services.
• Demonstrated experience in case management and helping vulnerable individuals and families navigate complex systems and connect to resources.
• Experienced with competently managing emergent, urgent and crisis situations with clients (i.e., child welfare, suicidal ideation, mental health concerns, etc.)
• Highly developed interpersonal skills including active listening, emotional de-escalation, patience, and compassion.
• Service-oriented leadership skills.
• Strong analytic problem-solving skills.
• Fluency in English, written and spoken. Fluency in Spanish a significant plus.
• Ability to work both independently and in a dynamic, cross-functional global team structure.
• Ability to manage and work through change in a proactive and positive manner.
• Must be cleared and approved by Office of Refugee Resettlement and background check including FBI fingerprints and Child Abuse and Neglect checks required upon hire (initiated by IRC after acceptance of the position).
Working Environment
• Remote Work. Up to 20% travel required.
Compensation: (Pay Range: $77,343 - $90,203.28) Posted pay ranges apply to US-based candidates. Ranges are based on various factors including the labor market, job type, internal equity, and budget. Exact offers are calibrated by work location, individual candidate experience and skills relative to the defined job requirements.
PROFESSIONAL STANDARDS
All International Rescue Committee workers must adhere to the core values and principles outlined in IRC Way - Standards for Professional Conduct. Our Standards are Integrity, Service, Equality and Accountability. In accordance with these values, the IRC operates and enforces policies on Safeguarding, Conflicts of Interest, Fiscal Integrity, and Reporting Wrongdoing and Protection from Retaliation. IRC is committed to take all necessary preventive measures and create an environment where people feel safe, and to take all necessary actions and corrective measures when harm occurs. IRC builds teams of professionals who promote critical reflection, power sharing, debate, and objectivity to deliver the best possible services to our clients.
Cookies: ***********************************************
Compensation: Posted pay ranges apply to US-based candidates. Ranges are based on various factors including the labor market, job type, internal equity, and budget. Exact offers are calibrated by work location, individual candidate experience and skills relative to the defined job requirements.
US Benefits: We offer a comprehensive and highly competitive set of benefits. In the US, these include: 10 sick days, 10 US holidays, 20-25 paid time off days depending on role and tenure, medical insurance starting at $163 per month, dental starting at $6.50 per month, and vision starting at $5 per month, FSA for healthcare and commuter costs, a 403b retirement savings plans with immediately vested matching, disability & life insurance, and an Employee Assistance Program which is available to our staff and their families to support counseling and care in times of crisis and mental health struggles.
Equal Opportunity Employer: IRC is an Equal Opportunity Employer. IRC considers all applicants on the basis of merit without regard to race, sex, color, national origin, religion, sexual orientation, age, marital status, veteran status, disability or any other characteristic protected by applicable law.
#li-1
$77.3k-90.2k yearly Auto-Apply 32d ago
Director, Clinical Research Operations
Care Access 4.3
Remote job
Care Access is working to make the future of health better for all. With hundreds of research locations, mobile clinics, and clinicians across the globe, we bring world-class research and health services directly to communities that often face barriers to care. We are dedicated to ensuring that every person has the opportunity to understand their health, access the care they need, and contribute to the medical breakthroughs of tomorrow.
With programs like
Future of Medicine
, which makes advanced health screenings and research opportunities accessible to communities worldwide, and
Difference Makers
, which supports local leaders to expand their community health and wellbeing efforts, we put people at the heart of medical progress. Through partnerships, technology, and perseverance, we are reimagining how clinical research and health services reach the world. Together, we are building a future of health that is better and more accessible for all.
To learn more about Care Access, visit *******************
How This Role Makes a Difference
The Director of Clinical Research Operations provides leadership and oversight for all clinical staff supporting brick-and-mortar research sites, mobile/pop-up sites, and hybrid clinical trial models. This role ensures high-quality study execution, regulatory compliance, and strong clinical performance across a geographically dispersed workforce, including traveling CRCs and mobile clinical teams.
How You'll Make An Impact
Clinical Operations Management
Oversight for traveling clinical staff supporting decentralized operations at events and sites.
Ensure high-quality protocol execution, participant safety, and adherence to GCP and FDA regulations.
Oversee clinical workflows at sites and mobile deployments, resolving issues impacting quality, recruitment, or compliance.
People Management
Manage, develop, and evaluate all clinical research staff (CRCs, nurses, mobile clinicians, and traveling staff).
Implement training, competency standards, and performance expectations for all clinical staff.
Provide input into staffing budgets, resource planning, and clinical support models.
Study Management
Monitor enrollment, data quality, documentation practices, and clinical performance metrics.
Partner with regulatory, medical, data, participant experience, and site operations teams to support successful trial delivery.
Drive continuous improvement in clinical quality, consistency, and operational efficiency.
The Expertise Required
Strong knowledge of ICH-GCP, FDA regulations, and clinical trial execution.
Excellent leadership, communication, and performance-management skills.
Ability to thrive in dynamic environments and manage diverse clinical teams.
Certifications/Licenses, Education, and Experience
Bachelor's degree in a health-related field required; advanced degree preferred.
12+ years of clinical research operations experience, including leadership of multisite or dispersed clinical teams
Experience overseeing CRCs, nurses, mobile clinicians, or traveling clinical staff.
How We Work Together
Location: Remote within the United States. This role requires 100% of work to be performed in a remote office environment.
Travel: This role requires up to 20-40% travel requirements further explained below. Length of travel will depend upon study requirements, staff needs, and company initiatives.
Type of Travel Required: National
Physical demands associated with this position Include: The ability to use keyboards and other computer equipment.
The expected base salary range for this role is $120,000 - $160,000 USD per year. In addition to base salary, this role is eligible for an annual discretionary bonus as part of its overall cash compensation.
Benefits & Perks (US Full Time Employees)
Paid Time Off (PTO) and Company Paid Holidays
100% Employer paid medical, dental, and vision insurance plan options
Health Savings Account and Flexible Spending Accounts
Bi-weekly HSA employer contribution
Company paid Short-Term Disability and Long-Term Disability
401(k) Retirement Plan, with Company Match
Diversity & Inclusion
We work with and serve people from diverse cultures and communities around the world. We are stronger and better when we build a team representing the communities we support. We maintain an inclusive culture where people from a broad range of backgrounds feel valued and respected as they contribute to our mission.
We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to, and will not be discriminated against on the basis of, race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.
Care Access is unable to sponsor work visas at this time.
If you need an accommodation to apply for a role with Care Access, please reach out to: ********************************
$120k-160k yearly Auto-Apply 8d ago
Residential Admin - Director of Residential Services-FT-GLOW
Arc Glow
Remote job
Director of Residential Services Status: Exempt Program: Residential Services Department: Residential Admin Responsible for oversight and operation of all assigned Arc GLOW Residential homes. Works to ensure that the services offered are of the highest quality and in accordance with the requirements of various governmental regulators. Creates an environment that promotes health and safety, and person-centered choices.
Essential Functions:
Ensures all pertinent legal and State/Federal administrative regulations and guidelines of Medicaid, OPWDD and the Agency are implemented and followed.
Attends any applicable meetings/trainings as a representative or liaison between the Agency and other Provider Agencies/Community Committees within the field. Attends conferences, training sessions, and pertinent meetings as designated (offsite locations included)
Acts as a resource person on Residential Programming for individuals, families and Agency staff.
Attends all applicable Agency meetings as assigned and appropriate.
Prepares and administers (in conjunction with the Vice President, Residential Services) the budget for the Residential Services Program. Maintains records as required by this Agency, and NYS/Federal regulations.
Ensures that appropriate supervision and evaluation of Residential Staff occurs per agency policy.
Participates in the hiring process of the Residential Services Staff.
Maintains a flexible schedule to provide assistance in emergency/crisis situations.
Ensures that program specific training is provided to all residential staff upon hire and as needed per regulation and agency policy.
Attends all Agency mandated in-service training sessions.
Coordinates, participates and monitors a departmental on call system for crisis program support 24 hours a day.
Coordinates ongoing Staff development by assisting individuals and groups in the design of projects and materials used to train both the Residents and Staff.
Develops services and programs to meet the designated, documented residential needs of our Residents in accordance with the continuum of services established in New York State by OPWDD and Medicaid.
Prepares and submits all reports required by OPWDD, Medicaid, this Agency or as requested by the Vice President, Residential Services
Ensures that Residential financial records are maintained and monitored per the Agency, OPWDD and SSA protocols.
Prepares residential programs for certification or re-certification by appropriate regulatory agencies and participates in regulatory audits.
Maintains policies and procedures of all Residential Programs to include updates, additions and provides information regarding same to Staff.
Ensures all departmental and Agency policies are being implemented and followed by program staff.
Participates in inter-disciplinary team and Staff meetings as needed and applicable.
Provides supervision and performance evaluation to all positions that report directly to the Director and provides necessary feedback per Agency policy.
Performs unannounced quarterly visits to all residential sites.
Reports all incidents, (behavior problems, health problems, accidents, etc.) to the appropriate agencies and necessary persons in a timely fashion as required by regulations and ensures appropriate follow up is completed.
Conducts self in such a manner as to meet Agency policies and standards at all times.
Participates in investigations in any matter related to the Agency, the Staff, or Program Participants.
Supports the mission of Arc GLOW by ensuring operational excellence and compliance that enables our team to provide high-quality, individualized supports.
Performs any other duties as deemed necessary
Punctuality and attendance during scheduled work hours are essential functions of this position.
Non-Essential Functions:
Participates in Corporate Compliance and Quality Assurance activities
Keeps abreast of best practices and new developments in the field
Serves on various committees (both internal and external as assigned)
Participates in Organization events
Supports organization grant opportunities
Reporting Responsibilities: Vice President, Residential Services
Supervisory Responsibilities: Directly supervises Residential Service Managers. Indirectly supervises other Residential Services employees
Knowledge, Skills & Abilities:
Requires good listening skills, excellent oral and written communication skills and good math and reading abilities. Basic computer skills required.
Must have sound judgment in decision making
Strong organizational skills and problem-solving skills, ability to evaluate and network.
Experience working with individuals with developmental disabilities and/or elderly helpful
Must be a positive role model and possess both excellent interpersonal skills and leadership abilities.
Must be able to work independently, as well as part of a team
Must be able to maintain composure during emergency or conflict situations
Physical Requirements:
Ability to use standard office equipment including personal computer, phone, fax, copier etc. Ability to drive a vehicle. Ability to speak, listen and sit. Lifting minimum of 20 lbs.
Be physically able to assist individuals in transferring from wheelchair to another seat when needed
Walk up and down stairs
Working Conditions:
Working conditions are normal for an office environment. Work may require occasional weekend and/or evening work. Will be required to travel to offsite work locations and may be required to travel overnight.
Minimum Requirements:
Bachelor's Degree in Human Services or related field with a minimum 3-years' experience serving individuals in a residential setting is required. A minimum of 5 years of supervisory experience is required.
New York State Driver's License with safe driving history as established by Agency policy.
$65k-108k yearly est. 11d ago
Clinical Program Manager RN - REMOTE - Days
Providence Health & Services 4.2
Remote job
Leads the alignment, standardization and ongoing improvement of ministry length of stay for designated patient populations. Serves as designated ministry liaison with providers and ministry Care Coordination teams, to move patients towards safe and effective discharge plans or transitions to the most appropriate next level of care.
Providence caregivers are not simply valued - they're invaluable. Join our team at St. Joseph Hospital Of Orange and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we Providence know that to inspire and retain the best people, we must empower them.
Required qualifications:
+ Associate's Degree in Nursing
+ Bachelor's Degree in Nursing. Or
+ Upon hire: California Registered Nurse License.
+ 3 years Experience in Utilization Management.
+ Experience working with InterQual and MCG guidelines.
Preferred qualifications:
+ Master's Degree in Nursing.
+ 5 years Experience as a utilization/case manager in an acute care setting.
+ Experience in a multi-hospital and/or integrated healthcare system.
Why Join Providence?
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
About Providence
At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.
Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
About the Team
The Sisters of Providence and Sisters of St. Joseph of Orange have deep roots in California, bringing health care and education to communities from the redwood forests to the beach shores of Orange county - and everywhere in between. In Southern California, Providence provides care throughout Los Angeles County, Orange County, High Desert and beyond.
Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care, and even our own Providence High School.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
Requsition ID: 410644
Company: Providence Jobs
Job Category: Clinical Administration
Job Function: Clinical Support
Job Schedule: Full time
Job Shift: Day
Career Track: Nursing
Department: 7540 SJO CASE MGMT
Address: CA Orange 1100 W Stewart Dr
Work Location: St Joseph Hospital-Orange
Workplace Type: Remote
Pay Range: $67.93 - $107.26
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
$68k-113k yearly est. Auto-Apply 5d ago
Manager, Clinical Operations - Full Service CRA Line Manager (Home-Based in Western US )
Syneos Health, Inc.
Remote job
Syneos Health is a leading fully integrated biopharmaceutical solutions organization built to accelerate customer success. We translate unique clinical, medical affairs and commercial insights into outcomes to address modern market realities. Our Clinical Development model brings the customer and the patient to the center of everything that we do. We are continuously looking for ways to simplify and streamline our work to not only make Syneos Health easier to work with, but to make us easier to work for.
Whether you join us in a Functional Service Provider partnership or a Full-Service environment, you'll collaborate with passionate problem solvers, innovating as a team to help our customers achieve their goals. We are agile and driven to accelerate the delivery of therapies, because we are passionate to change lives.
Discover what our 29,000 employees, across 110 countries already know:
WORK HERE MATTERS EVERYWHERE
Why Syneos Health
* We are passionate about developing our people, through career development and progression; supportive and engaged line management; technical and therapeutic area training; peer recognition and total rewards program.
* We are committed to our Total Self culture - where you can authentically be yourself. Our Total Self culture is what unites us globally, and we are dedicated to taking care of our people.
* We are continuously building the company we all want to work for and our customers want to work with. Why? Because when we bring together diversity of thoughts, backgrounds, cultures, and perspectives - we're able to create a place where everyone feels like they belong.
Job Responsibilities
Core Responsibilities
* Line management of Clinical Operations staff, responsibilities including interviewing and selection, termination, professional development, performance appraisals, and employee counselling May be involved in assignment of project work and will review workloads for all direct reports. Manages staff by establishing goals that will increase knowledge and skill levels, and by delegating tasks commensurate with skill level.
* Review workload for all staff in reporting chain, participate in managing the resource availability for the assigned staff, providing support that projects are suitably resourced and staffing needs are identified in a timely fashion.
* Provide expert operational oversight and guidance to support prioritization of activities, review and monitor the work performed, metric compliance, and development of contingency plans, among others.
* Assist in recruiting new staff, including participation in interview process and new hire on boarding. Proactively work to ensure staff retention and turnover rates remain within expected levels.
* Ensure quality and adherence to Standard Operating Procedures/Work Instructions (SOP/WIs) and compliance with federal and local guidelines and ICH GCP. Ensure all staff follow required training and complete required documentation. Provide regular updates to management accordingly.
* Work closely within appropriate business unit/region to ensure staff performance on studies and correct deficiencies as identified by staff, customers, and auditors. Able to contribute to BU level process improvements. May provide business development support.
* May conduct several types of sign off and assessment visits to ensure Clinical Operations on-site performance. Develop and oversee training plans to address performance deficiencies. Ensure staff adhere to training guidelines, training records maintenance, and individual and corporate training needs are identified and addressed.
* Organize and chair clinical staff meetings at regular intervals. Manage issues and provide follow up for action items requiring resolution.
* Facilitate and support project and team/country reviews with Clinical Operations staff, focusing on budget, schedule, and risk analysis. Use department systems, reports, and dashboards to identify performance issues, process gaps and monitor overall performance progress in line with departmental goals and metric targets. Oversee all quality control efforts of assigned teams.
Qualifications
* Bachelor's degree in life sciences, nursing degree, or equivalent related experience, plus extensive clinical research experience in a contract research organization, pharmaceutical or Biotechnology Company, including some time in a leadership capacity or equivalent combination of education, training and experience is required.
* Extensive knowledge of GCP/ICH guidelines and other applicable regulatory requirements
* Excellent communication, presentation, interpersonal, and change management skills, both written and spoken, with an ability to inform, influence, convince, and persuade.
* Strong time management, technical and organizational skills. Ability to work independently and within a team environment.
* Knowledge of basic financial concepts as related to forecasting and budgeting. Understands project budgets.
* Must demonstrate good computer skills and be able to embrace modern technologies.
* Ability to travel as necessary (up to 25%)
At Syneos Health, we believe in providing an environment and culture in which Our People can thrive, develop and advance. We reward and recognize our people by providing valuable benefits and a quality-of-life balance. The benefits for this position may include a company car or car allowance, Health benefits to include Medical, Dental and Vision, Company match 401k, eligibility to participate in Employee Stock Purchase Plan, Eligibility to earn commissions/bonus based on company and individual performance, and flexible paid time off (PTO) and sick time. Because certain states and municipalities have regulated paid sick time requirements, eligibility for paid sick time may vary depending on where you work. Syneos complies with all applicable federal, state, and municipal paid sick time requirements.
Salary Range:
The base salary range represents the anticipated low and high of the Syneos Health range for this position. Actual salary will vary based on various factors such as the candidate's qualifications, skills, competencies, and proficiency for the role.
Get to know Syneos Health
Over the past 5 years, we have worked with 94% of all Novel FDA Approved Drugs, 95% of EMA Authorized Products and over 200 Studies across 73,000 Sites and 675,000+ Trial patients.
No matter what your role is, you'll take the initiative and challenge the status quo with us in a highly competitive and ever-changing environment. Learn more about Syneos Health.
***************************
Additional Information
Tasks, duties, and responsibilities as listed in this are not exhaustive. The Company, at its sole discretion and with no prior notice, may assign other tasks, duties, and job responsibilities. Equivalent experience, skills, and/or education will also be considered so qualifications of incumbents may differ from those listed in the Job Description. The Company, at its sole discretion, will determine what constitutes as equivalent to the qualifications described above. Further, nothing contained herein should be construed to create an employment contract. Occasionally, required skills/experiences for jobs are expressed in brief terms. Any language contained herein is intended to fully comply with all obligations imposed by the legislation of each country in which it operates, including the implementation of the EU Equality Directive, in relation to the recruitment and employment of its employees. The Company is committed to compliance with the Americans with Disabilities Act, including the provision of reasonable accommodations, when appropriate, to assist employees or applicants to perform the essential functions of the job.
Summary
Accountable for and provides management support and direct supervision to Clinical Operations staff in the assigned areas including Site Selection support, site contracts support, regulatory/ethics submissions, site activities including site activation as well as On-Site Monitoring and/or Central Monitoring through Study Close Out. Provides training, consultation and oversees metric compliance and quality related to operating activities of assigned staff to ensure project deliverables are met. Collaborates and oversees Clinical Operations Team to ensure fulfillment of customer requirements and compliance with related regulations. Supports senior management in operational level planning. May participate in business development presentations as a subject matter expert in Clinical Operations functions within the Company.
$60k-97k yearly est. 15d ago
CCO In Training, Director of Clinical Services
Pennant Group
Remote job
This opportunity will be on-site in Colorado, Oklahoma or Wisconsin.
Cornerstone, part of The Pennant Group family, is currently seeking entrepreneurial-minded leaders with proven results in building and leading exceptional clinical teams - and has a passion for the home health, hospice and home care industry. Join us in making an impact and shaping the future of home healthcare!
About the Opportunity:
The CCO-in-Training (CCIT) Program is a 12-week, full time paid executive training program designed to prepare outstanding leaders for an opportunity to lead and manage clinical services and teams in a home health, hospice, or home care setting. CCITs learn how to drive results, cultivate a strong team culture, and develop a deep understanding of the unique business model that powers Pennant's success.
Successful CCIT graduates may advance to lead one of our thriving agencies or future agencies, with continued mentorship and operational support from experienced clinical partners. As a CCIT, you will gain hands-on practical experience in high quality clinical care services, agency operations, administrative support, and people leadership skills to equip you to take on a more strategic and elevated Director of Clinical Services position (or equivalent). The CCIT program offers mentorship, cross-functional training, and real responsibility in a dynamic environment.
Key Responsibilities:
Engage in immersive, on-the-job training across clinical, operational and administrative management functions.
Shadow department heads and front-line staff to understand the day-to-day rhythm of agency operations, processes, and clinical controls.
Take the lead on real-time projects and contribute to meaningful improvements within your host agency.
Prepare for a Director-level role by mastering staffing, team engagement, and community growth initiatives.
Study relevant state regulations and best practices in home healthcare operations.
Align leadership and interpersonal skills with our CAPLICO core values and mission.
Qualifications:
Current, unencumbered, active license to practice as a Registered Nurse, Speech-Language Pathologist, Occupational Therapist, or Social Worker in the state where services are rendered; must maintain applicable state licensure requirements at hire, and for the entire duration of employment.
Minimum of one (1) year of experience required, preferably in a home health or hospice treatment setting.
Current and nationally accredited CPR certification.
Enthusiasm, passion for working with people, and an internal drive to improve the lives of individuals in our care.
Must understand and adhere to the ethical standards of the respective licensure governing board.
Must have a valid driver's license, current automobile insurance, and a safe driving record.
Open to relocation based on available opportunities
About Us:
Cornerstone, an affiliate of The Pennant Group (NASDAQ: PNTG), is committed to delivering compassionate, personalized care to patients and families in the comfort of their own homes. As part of the Pennant family-a growing national network with over 180 affiliated locations across 14 states spanning home health, hospice, and senior living-we operate with the independence and flexibility that allow our local leaders to truly make a difference. Pennant Services provides robust clinical, legal, accounting, IT and HR support, enabling our teams to focus on delivering exceptional service and care.
We are guided by the core values that shape Pennant's unique culture:
Customer Second
Accountability
Passion for Learning
Love One Another
Intelligent Risk Taking
Celebrate
Ownership
We believe in empowering our people, fostering excellence, and creating an environment where personal and professional growth thrives. Our culture makes Pennant a truly unique place to work.
The employer for this position is stated in the job posting. The Pennant Group, Inc. is a holding company of independent operating subsidiaries that provide healthcare services through home health and hospice agencies and senior living communities located throughout the US. Each of these businesses is operated by a separate, independent operating subsidiary that has its own management, employees and assets. More information about The Pennant Group, Inc. is available at ****************************
#onsite
The employer for this position is stated in the job posting. The Pennant Group, Inc. is a holding company of independent operating subsidiaries that provide healthcare services through home health and hospice agencies and senior living communities located throughout the US. Each of these businesses is operated by a separate, independent operating subsidiary that has its own management, employees and assets. More information about The Pennant Group, Inc. is available at ****************************
$75k-109k yearly est. Auto-Apply 17d ago
Manager, Clinical Services
Allied Benefit Systems 4.2
Remote job
The Clinical Services Manager provides leadership and oversight to a multidisciplinary team of clinicians-including nurses, pharmacists, nutritionists, and other licensed professionals-responsible for conducting case evaluations, identifying opportunities to engage members in improving their health, and submitting referrals to appropriate programs. This role ensures operational excellence, compliance, and continuous improvement in clinical workflows. The supervisor will leverage clinical expertise and analytical skills to review documentation, interpret medical records, understand health plan benefits, and support product implementation initiatives.
ESSENTIAL FUNCTIONS:
Supervise and mentor a team of clinicians, ensuring adherence to clinical standards, documentation requirements, and organizational policies.
Oversee case evaluation processes to identify gaps in care, opportunities for member engagement, and appropriate program referrals.
Provide coaching, performance evaluations, and ongoing professional development opportunities.
Monitor productivity, quality, and engagement metrics; implement corrective actions as needed.
Analyze clinical and operational data to identify trends, gaps, and improvement opportunities.
Prepare and present reports on team performance, member outcomes, and program effectiveness to leadership.
Collaborate with internal leadership stakeholders to provide clinical recommendations and best practices in the development and seamless integration of new products and services.
Participate in cross-functional initiatives to enhance member experience and health outcomes
Lead, coach, motivate and develop. Responsible for one-on-one meetings, performance appraisals, growth opportunities and attracting new talent.
Clearly communicate expectations, provide employees with the training, resources, and information needed to succeed.
Actively engage, coach, counsel and provide timely, and constructive performance feedback.
Other duties as assigned.
.Other duties as assigned.
EDUCATION:
Bachelor's Degree in Nursing required
Registered Nurse or Physician Assistant license required.
EXPERIENCE & SKILLS:
A minimum of 7 years of Clinical Experience preferred.
A minimum of 1 year of Managed Care/Discharge Planning preferred
Nursing and concurrent review
Experience, preferably from a third-party administrator, carrier, or within the healthcare industry.
Experience managing teams of employees with a variety of background and tenure.
Ability to monitor and prioritize multiple deadlines and projects simultaneously.
Experience reading, analyzing, and reviewing organizational metrics and data, preferred.
Highly skilled in written and verbal communication, also including client focused presentations.
POSITION COMPETENCIES:
Accountability
Communication
Action Oriented
Timely Decision Making
Building Relationships/Shaping Culture
Customer Focus
PHYSICAL DEMANDS
This is a standard desk role - long periods of sitting and working on a computer are required.
WORK ENVIRONMENT
Remote
Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive.
The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.
Compensation is not limited to base salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life & Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.
Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time. All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process. It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.
Protect Yourself from Hiring Scams
Important Notice About Our Hiring Process
To keep your experience safe and transparent, please note:
All interviews are conducted via video.
No job offer will ever be made without a video interview with Human Resources and/or the Hiring Manager.
If someone contacts you claiming to represent us and offers a position without a video interview, it is not legitimate. We never ask for payment or personal financial information during the hiring process.
For your security, please verify all job opportunities through our official careers page: Current Career Opportunities at Allied Benefit Systems
Your security matters to us-thank you for helping us maintain a fair and trustworthy process!
$64k-83k yearly est. 11d ago
Director, Clinical Care Services - New Mexico, Remote
Magellan Health 4.8
Remote job
This is a remote position supporting New Mexico. Candidate needs to be licensed in the State where they reside.
Maintains accountability for medical management functions to achieve the business and clinical outcomes for the health plan, meeting contract requirements, National Committee of Quality Assurance (NCQA) accreditation standards, and supporting initiatives with providers and members to manage cost of care. Oversees utilization management and criteria-based reviews of care, clinical appeals regarding medical necessity, and the interaction with claims payment policies and processes. Also oversees the health plans 24/7 Nurse Line program and the clinical management of crisis calls. Depending on SBU/product supported, supports goals, contracts, and accreditation requirements of health plan in conducting reviews of clinical interactions and clinical documentation including reviews of case management, utilization management, vendor, and provider records. Collects data following established procedures and analyzes findings for purposes of continuous quality improvement and for internal and external reporting. Interacts with multiple stakeholders internally and externally. Conduct staff audits, process audits and pre-delegation and delegation activities. Reviews audit results with appropriate stakeholder and manages trainings in conjunction with the trainer for individual and/or for unit learning gaps.
Directs, coordinates and evaluates efficiency and productivity of utilization management functions. Works closely with SBU and vendors to assure integration, oversight, and efficiency of utilization management and appeals processes and for delegated functions. In collaboration with the national clinical team, assures that all utilization management-related activities meet the standards required for the state contract and NCQA.
Leads and organizes the ongoing evaluation of the utilization management program against quality and utilization benchmarks and targets. Identifies opportunities for improvement; organizes and manages cost of care initiatives. Collaborates with local and national leaders including Quality Improvement, Analytics, Finance, Network, and other areas to assure a comprehensive approach to managing quality of care, service, and cost of care. Provides expert input to Finance regarding patterns of utilization and cost and high cost cases.
Assures staff selection, training, and evaluation to promote the development of a high quality team and effective transitions of care with the clinical care teams.
Works closely with and provides input to national health plan clinical team on program design, policies, procedures, workflows, and correspondence.
Collaborates with Network leaders to design and implement successful methods for working with hospitals, home health, and other services providers. Ensures integration and efficiency of Network strategy and vendor relationships with utilization management and claims processes. Works closely with network on the training and evaluation of providers as well in resolving provider related issues.
Directs staff who assure quality, inter-rater reliability and standards are met in daily operations. Responsible for resolution and communication of utilization management issues and concerns and corrective action plan activities and reporting.
Participates as a member of health plan Quality Insurance Committee and co-chair health plan Utilization Management Committee.
Collects, analyzes and prepares record/documents information for projects related to assessing the efficiency, effectiveness and quality of the delivery of managed care services. Prepares monthly performance reports with audit results. Presents findings at provider, customer, UM and CM meetings as needed.
Audits and reviews case manager, Health guide, UM staff, vendor, and provider documentation and telephone interactions against health services quality monitoring standards, regulations, accreditation standards and contract requirements. Reviews vendor and/or provider records against clinical and procedural established standards and contract requirements.
Leads and conducts ongoing activities which monitor established quality of care standards in the participating provider network, vendors, UM staff, Health Guides, and for case managers.
Assists in the planning and implementation of activities to improve delivery of services and quality of care including the development and coordination of in-service education programs for vendors, providers, UM staff, and case managers. Makes recommendations as to required training based upon audit results.
Responsible for monitoring and validating internal audit results and/or corrective action plans.
Other duties as assigned.
The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description.
Other Job Requirements
Responsibilities
3+ years in utilization management operations.
5+ years in health care quality improvement.
Licensure is required for this position, specifically a current license that meets State, Commonwealth or customer-specific requirements. One or more of the following current, active licenses are required: BCBA, LCMFT, LCSW, LMHP, LPC, LPT, LOT or RN.
Must have experience overseeing contractual performance standards.
Experience with reporting and analyzing managed care utilization data.
Strong verbal and written communications skills.
General Job Information
Title
Director, Clinical Care Services - New Mexico, Remote
Grade
30
Work Experience - Required
Clinical, Management/Leadership, Quality, Utilization Management
Work Experience - Preferred
Education - Required
Bachelor's - Nursing, Bachelor's - Occupational Therapy, Bachelor's - Physical Therapy, Master's - Behavioral Health
Education - Preferred
License and Certifications - Required
BCBA - Board Certified Behavior Analyst - Care MgmtCare Mgmt, LCMFT - Licensed Clinical Marriage and Family Therapist - Care MgmtCare Mgmt, LCSW - Licensed Clinical Social Worker - Care MgmtCare Mgmt, LMFT - Licensed Marital and Family Therapist - Care MgmtCare Mgmt, LMHP - Licensed Mental Health Professional - Care MgmtCare Mgmt, LPC - Licensed Professional Counselor - Care MgmtCare Mgmt, OT - Occupational Therapist, State Licensure - Care MgmtCare Mgmt, PT - Physical Therapist, State Licensure - Care MgmtCare Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care MgmtCare Mgmt
License and Certifications - Preferred
Salary Range
Salary Minimum:
$105,230
Salary Maximum:
$178,890
This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.
This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
$105.2k-178.9k yearly Auto-Apply 15d ago
Manager, Clinical Operations - Full Service CRA Line Manager (Home-Based in Western US )
Syneos Health Clinical Lab
Remote job
Syneos Health is a leading fully integrated biopharmaceutical solutions organization built to accelerate customer success. We translate unique clinical, medical affairs and commercial insights into outcomes to address modern market realities.
Our Clinical Development model brings the customer and the patient to the center of everything that we do. We are continuously looking for ways to simplify and streamline our work to not only make Syneos Health easier to work with, but to make us easier to work for.
Whether you join us in a Functional Service Provider partnership or a Full-Service environment, you'll collaborate with passionate problem solvers, innovating as a team to help our customers achieve their goals. We are agile and driven to accelerate the delivery of therapies, because we are passionate to change lives.
Discover what our 29,000 employees, across 110 countries already know:
WORK HERE MATTERS EVERYWHERE
Why Syneos Health
We are passionate about developing our people, through career development and progression; supportive and engaged line management; technical and therapeutic area training; peer recognition and total rewards program.
We are committed to our Total Self culture - where you can authentically be yourself. Our Total Self culture is what unites us globally, and we are dedicated to taking care of our people.
We are continuously building the company we all want to work for and our customers want to work with. Why? Because when we bring together diversity of thoughts, backgrounds, cultures, and perspectives - we're able to create a place where everyone feels like they belong.
Job Responsibilities
Core Responsibilities
Line management of Clinical Operations staff, responsibilities including interviewing and selection, termination, professional development, performance appraisals, and employee counselling May be involved in assignment of project work and will review workloads for all direct reports. Manages staff by establishing goals that will increase knowledge and skill levels, and by delegating tasks commensurate with skill level.
Review workload for all staff in reporting chain, participate in managing the resource availability for the assigned staff, providing support that projects are suitably resourced and staffing needs are identified in a timely fashion.
Provide expert operational oversight and guidance to support prioritization of activities, review and monitor the work performed, metric compliance, and development of contingency plans, among others.
Assist in recruiting new staff, including participation in interview process and new hire on boarding. Proactively work to ensure staff retention and turnover rates remain within expected levels.
Ensure quality and adherence to Standard Operating Procedures/Work Instructions (SOP/WIs) and compliance with federal and local guidelines and ICH GCP. Ensure all staff follow required training and complete required documentation. Provide regular updates to management accordingly.
Work closely within appropriate business unit/region to ensure staff performance on studies and correct deficiencies as identified by staff, customers, and auditors. Able to contribute to BU level process improvements. May provide business development support.
May conduct several types of sign off and assessment visits to ensure Clinical Operations on-site performance. Develop and oversee training plans to address performance deficiencies. Ensure staff adhere to training guidelines, training records maintenance, and individual and corporate training needs are identified and addressed.
Organize and chair clinical staff meetings at regular intervals. Manage issues and provide follow up for action items requiring resolution.
Facilitate and support project and team/country reviews with Clinical Operations staff, focusing on budget, schedule, and risk analysis. Use department systems, reports, and dashboards to identify performance issues, process gaps and monitor overall performance progress in line with departmental goals and metric targets. Oversee all quality control efforts of assigned teams.
Qualifications
Bachelor's degree in life sciences, nursing degree, or equivalent related experience, plus extensive clinical research experience in a contract research organization, pharmaceutical or Biotechnology Company, including some time in a leadership capacity or equivalent combination of education, training and experience is required.
Extensive knowledge of GCP/ICH guidelines and other applicable regulatory requirements
Excellent communication, presentation, interpersonal, and change management skills, both written and spoken, with an ability to inform, influence, convince, and persuade.
Strong time management, technical and organizational skills. Ability to work independently and within a team environment.
Knowledge of basic financial concepts as related to forecasting and budgeting. Understands project budgets.
Must demonstrate good computer skills and be able to embrace modern technologies.
Ability to travel as necessary (up to 25%)
At Syneos Health, we believe in providing an environment and culture in which Our People can thrive, develop and advance. We reward and recognize our people by providing valuable benefits and a quality-of-life balance. The benefits for this position may include a company car or car allowance, Health benefits to include Medical, Dental and Vision, Company match 401k, eligibility to participate in Employee Stock Purchase Plan, Eligibility to earn commissions/bonus based on company and individual performance, and flexible paid time off (PTO) and sick time. Because certain states and municipalities have regulated paid sick time requirements, eligibility for paid sick time may vary depending on where you work. Syneos complies with all applicable federal, state, and municipal paid sick time requirements.
Salary Range:
The base salary range represents the anticipated low and high of the Syneos Health range for this position. Actual salary will vary based on various factors such as the candidate's qualifications, skills, competencies, and proficiency for the role.
Get to know Syneos Health
Over the past 5 years, we have worked with 94% of all Novel FDA Approved Drugs, 95% of EMA Authorized Products and over 200 Studies across 73,000 Sites and 675,000+ Trial patients.
No matter what your role is, you'll take the initiative and challenge the status quo with us in a highly competitive and ever-changing environment. Learn more about Syneos Health.
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Additional Information
Tasks, duties, and responsibilities as listed in this are not exhaustive. The Company, at its sole discretion and with no prior notice, may assign other tasks, duties, and job responsibilities. Equivalent experience, skills, and/or education will also be considered so qualifications of incumbents may differ from those listed in the Job Description. The Company, at its sole discretion, will determine what constitutes as equivalent to the qualifications described above. Further, nothing contained herein should be construed to create an employment contract. Occasionally, required skills/experiences for jobs are expressed in brief terms. Any language contained herein is intended to fully comply with all obligations imposed by the legislation of each country in which it operates, including the implementation of the EU Equality Directive, in relation to the recruitment and employment of its employees. The Company is committed to compliance with the Americans with Disabilities Act, including the provision of reasonable accommodations, when appropriate, to assist employees or applicants to perform the essential functions of the job.
$60k-90k yearly est. Auto-Apply 16d ago
Clinical Relations Manager
Global 4.1
Remote job
How will you make an impact?
Manages identified Clinical Sites to educate prospective study subjects and health care professionals about clinical trial participation. Takes on added responsibility as requested from VP of Clinical Relations to assist the team in achieving Glaukos clinical enrollment goals. The specific tasks could be: new employee training, planning and leading Glaukos study investigators meetings, planning and implementing scheduled Investigator conference calls, overseeing the creation and delivery of monthly clinical study newsletters, Updating iPad with CRM study tools, performing the functions of CRM while also executing the Surgical Specialist tasks on identified trained Investigators, leading the team with updates with tracking subject software (iMednet), development of tools for scheduling clinical surgery, development of patient out-reach programs, development of surveys to track performance from our customers, attendance as needed to major local, regional, national, international industry meetings, development of surgical forms as needed as technique is developed for new Glaukos products. Being prepared as a back-up to the CRA to deliver the "Excellence in Research" program, Take the lead as directed on developing the system for Glaukos in-office surgery.
What will you do?
Leads clinical recruitment efforts on key US IDE and post-approval trials.
Acts as an integral member of the core project team working directly with the Clinical Affairs team (Directors or Managers of Clinical Affairs, and Clinical Research Associates) and the Surgical Specialists (Regional Business Managers), and any other relevant team members.
Develops strong personal relationships with study investigators, clinical coordinators, and glaucoma/cataract key opinion leaders.
Establishes and builds rapport with clinical sites and assess their recruitment challenges and opportunities.
Based on a thorough assessment, develops a detailed and specific subject recruitment plan for clinical sites participating in Glaukos-sponsored studies.
Implements and facilitates subject recruitment and retention activities.
Analyzes metrics to identify trends, issues, areas of success and for improvement.
Identifies and proposes strategies, procedures, systems, technology etc. to improve productivity and efficiencies in clinical trial subject recruitment.
Develops detailed site specific study pre-screening plans based on protocol inclusion/exclusion criteria. Performs and oversees patient chart reviews to identify potential study subjects.
Complies with HIPAA, pertinent federal and state laws and regulations, and relevant Glaukos internal procedures.
Identifies outreach opportunities to educate patients, health care professionals, advocacy groups, and potential referring physicians about study participation.
Monitors referral sources to ensure adequate study information is provided to potential participants.
Identifies, coordinates, and staffs appropriate events and meetings, as needed.
Proactively and effectively communicates updates on site status to clinical management, Clinical Affairs, and RBMs.
Communicates trends in the industry and, whenever possible, status of competitive clinical trials.
Determines best practices for working with sites on increasing subject enrollment.
Works with other respective Clinical Relations Managers to elevate team success.
Attends major ophthalmic meetings, as needed.
Provide training to ophthalmology practices on how to properly and efficiently identify patients within their practice who are potential candidates for commercial iStent implantation.
Employ effective tools and programs to properly communicate the potential benefits of iStent implantation to appropriately identified patients.
How You'll Get there:
Minimum 9+ years relevant work experience in the medical device or pharmaceutical industry, preferably with experience in ophthalmology and medical devices. Required
Knowledge of medical terminology required, with knowledge of ophthalmology terminology strongly preferred Required
Prior experience in business development or as a study coordinator or clinical research assistant desirable Required
Prior experience developing and executing training plans Required
Knowledge of the medical, scientific, design, and clinical research aspect of medical device and/or pharmaceutical trials Required
Strong communication, interpersonal, and analytical skills Required
Excellent time management and organizational skills Required
Experience in MS Office (Outlook, Word, Excel); familiarity with databases helpful Required
Self-motivated and able to work independently, as well as within a team in a multidisciplinary environment Required
Must be willing and able to travel a significant amount of time (> 50%) Required Flexibility, as assignments vary in location, time intensity Required
Exhibits personal integrity, credibility, and responsibility Required
Bachelor's Degree with major in biological science, nursing, or other health-related discipline preferred
COA - Certified Ophthalmic Assistant Preferred COT - Certified Ophthalmic Medical Tech Preferred
#GKOSUS
$66k-104k yearly est. Auto-Apply 13d ago
Clinical, Manager, Prior Authorization Technician
Capital Rx 4.1
Remote job
About Judi Health
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:
Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,
Judi Healthâ„¢, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and
Judi , the industry's leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.
Together with our clients, we're rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit ****************
Location: Remote (For Non-Local) or Hybrid (Local to NYC area)
Position Responsibilities:
Oversee a dynamic team of pharmacy technicians engaged in the prior authorization process.
Analyze available data to provide prior authorization staffing, workflow, and system enhancement recommendations to maximize team agility and performance.
Actively participate in the prior authorization technician metric and quality goal setting process.
Generate and deliver comprehensive reports on prior authorization technician metrics to both internal and external stakeholders.
Assist the talent acquisition team in the hiring, evaluation, training, and onboarding of new employees.
Investigate/resolve escalated issues or problems from team members, clients, and other internal teams.
Key stakeholder in ensuring the prior authorization review platform is optimized for technician functions.
Maintain relationships with external Independent Review Organizations and clinical resource vendors.
Support the training and growth of both new and existing staff members in adherence to proper procedures.
Collaborate with prior authorization leadership to develop process improvements and support long-term business needs, recommend new approaches, policies, and procedures to influence continuous improvements in department's efficiency and help establish best practices for conflict resolution while actively participating in problem identification and coordinate resolutions between appropriate parties.
Assists with in other responsibilities, projects, implementations, and initiatives as needed in accordance with the policies and procedures established within the department.
Prepare prior authorization requests received by validating prescriber and member information, level of review, and appropriate clinical guidelines.
Maintain compliance with local, state, and federal laws, in addition to established organizational standards.
Proactively obtains clinical information from prescribers, referral coordinators, and appropriate staff to ensure all aspects of clinical guidelines are addressed for pharmacist review.
Triage phone calls from members, pharmacy personnel, and providers by asking applicable drug and client specific clinical questions.
Follow all internal Standard Operating Procedures and adhere to HIPAA guidelines and Company policies
Required Qualifications:
Active, unrestricted, National Certified Pharmacy Technician (CPhT) license required
Bachelor's or Associate's degree is preferred
4+ years of PBM or Managed Care pharmacy experience required
Proficient in Microsoft Office Suite with emphasis on Microsoft Excel and PowerPoint
Strong clinical background required
Excellent communication, writing, and organizational skills
Ability to multi-task and collaborate in a team with shifting priorities
Preferred Qualifications:
2+ years of regulated market prior authorization operations experience or knowledge of how to operationalize regulated market requirements
Previous prior authorization operations leadership experience
Salary Range$80,000-$90,000 USD
All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.
Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at *********************************************
$80k-90k yearly Auto-Apply 7d ago
Associate Director , Client Delivery - Clinical Research - Central Labs Services
Labcorp 4.5
Remote job
At Labcorp, we believe in the power of science to change lives. We are a leading global life sciences company that delivers answers for crucial health questions. Through our unparalleled diagnostics and drug development capabilities, we provide insights and accelerate innovations that not only empower patients and providers but help medical, biotech, and pharmaceutical companies transform ideas into innovations.
Central Laboratory Services is part of a global contract research organization within Labcorp. We offer the world's largest network of central laboratories and support global clinical trials testing. A common set of processes, procedures, and instrumentation is offered throughout our sites in Europe, Asia/Pacific, and the United States, allowing us to receive samples globally and provide more than 700 assays across all laboratory science disciplines.
LabCorp is seeking an Associate Director, Global Client Delivery, to join our Central Labs Services team. In this position, you will be accountable to create, implement and advance the Study Management function's vision and strategy in alignment with the Global Project Management (PM) strategy. This position is directly responsible for the day-to-day management and supervision of the study management team to ensure the successful implementation of the global project management strategy, structure, process, and metrics to deliver outstanding customer satisfaction.
The Associate Director will ensure integrated services with other global parts of Global Project Management, across departments and business units, focusing on innovative solutions to meet the needs of the pharmaceutical and biotech industries. The three primary areas of focus are:
People: Provide an environment where people can build their careers and thrive
Process: Contribute to an ongoing and sustainable improvement in cost, quality and service delivery for the Portfolio Manager, GSM and SDL functions.
Client: Deliver market-leading quality in an environment of increased regulatory scrutiny through a systematic quality program with focus on continuous improvement.
This is a remote opportunity and can be located anywhere in the US. Indianapolis metro area preferred.
Responsibilities:
Manage and supervise the day-to-day operations of the project management team including but not limited to:
Ensure the development of a competent workforce to meet growth plans within budget.
Ensure the seamless integration of project management services and influence pan-Labcorp Drug Development as necessary.
Accountable for the activities and outcomes of the project management team(s), taking corrective action where appropriate.
Ensure appropriate resource allocation to successfully implement and execute project plans to achieve agreed upon service levels.
Ensure consistent implementation, use, and review of SOPs.
Establish and monitor performance objectives for direct reports and take corrective action where appropriate.
Complete thorough, timely and well-documented performance evaluations and interim progress reviews.
Lead the study management team tasks related to planning, budgeting, and cross project management team issues.
Participate in the Project and Alliance Leadership team to establish strategy and business plans.
Engage in mentoring and developing staff and participate in Talent Assessment and Succession Planning processes.
Champion the PM Excellence strategy to continue to grow and enhance the PM competencies across the organization. Engage and partner with other PM pan-Labcorp Drug Development to share best practices and develop appropriate partnerships.
Drive a culture of continuous improvement, quality, and productivity.
Identify business growth opportunities and project management service enhancements. Monitor, track, and manage progress to the PM strategy. Share learning and best practices as appropriate.
Ensure all service failures and opportunities (CCLS and pan-Labcorp Drug Development) are identified, tracked, and resolved in a timely manner. Take preventative action to ensure that the same service failure(s) does not occur. Share learning and best practices as appropriate.
Accountable for the effective management of the study management team budget as appropriate.
Effectively partner and influence across CLS Leadership, Alliance Leaders, Business Development Directors, and Executive Sponsors to meet the growing and evolving client needs.
Minimum Experience Required:
Minimum 5 years of people leadership experience
Experience managing a team of up to 20 plus is preferred
Excellent written, verbal, and interpersonal skills
Demonstrated high degree of initiative and ability to work collaboratively
Proven ability to inspire effective teamwork and motivate staff in a multi-regional, matrixed environment
Knowledge of regulatory requirements in clinical or laboratory settings
Strong negotiation skills to facilitate, guide, and influence a unified approach within a global, cross-functional environment
Proven strength in planning, problem solving, and organization
Consistent track record of driving continuous improvement and achieving results through leadership
Demonstrated ability to interact with, influence and inspire staff at all levels of the organization
Inclusive and engaging presentation and communication skills
Demonstrated leadership development capabilities
Minimum Education/Qualifications/Certifications and Licenses Required:
4-year degree
Clinical trial or central laboratory experience in a people leadership role
Regulatory experience (GXP)
Preferred Education:
MBA or master's degree
Application Window: closes at the end of the day 1/30/2026
Pay Range: 130-160K per annum
All job offers will be based on a candidate's skills and prior relevant experience, applicable degrees/certifications, as well as internal equity and market data.
The position is also eligible for an annual bonus under the Labcorp Bonus Plan. Bonuses are payable based on corporate and/or business segment performance and are subject to individual performance modifiers.
Benefits: Employees regularly scheduled to work 20 or more hours per week are eligible for comprehensive benefits including: Medical, Dental, Vision, Life, STD/LTD, 401(k), Paid Time Off (PTO) or Flexible Time Off (FTO), Tuition Reimbursement and Employee Stock Purchase Plan. Casual, PRN & Part Time employees regularly scheduled to work less than 20 hours are eligible to participate in the 401(k) Plan only. For more detailed information, please click here.
Labcorp is proud to be an Equal Opportunity Employer:
Labcorp strives for inclusion and belonging in the workforce and does not tolerate harassment or discrimination of any kind. We make employment decisions based on the needs of our business and the qualifications and merit of the individual. Qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, childbirth, or related medical conditions), family or parental status, marital, civil union or domestic partnership status, sexual orientation, gender identity, gender expression, personal appearance, age, veteran status, disability, genetic information, or any other legally protected characteristic. Additionally, all qualified applicants with arrest or conviction records will be considered for employment in accordance with applicable law.
We encourage all to apply
If you are an individual with a disability who needs assistance using our online tools to search and apply for jobs, or needs an accommodation, please visit our accessibility site or contact us at Labcorp Accessibility. For more information about how we collect and store your personal data, please see our Privacy Statement.
$69k-89k yearly est. Auto-Apply 4d ago
Behavioral Health Clinical Review Manager
Bluecross Blueshield of Tennessee 4.7
Remote job
Are you passionate about making a meaningful impact on the lives of individuals facing mental health challenges, while working behind the scenes? If so, Utilization Management might be the perfect fit for you! In this role, you'll play a critical part in shaping care decisions and improving outcomes, all without direct, face-to-face interaction.
What You'll Do
Apply your knowledge of Behavioral Health and Withdrawal Management diagnoses.
Navigate the continuum of care and levels of care for Behavioral Health and Withdrawal Management.
Present cases confidently and effectively during clinical rounds.
Work independently with minimal supervision.
Excel in a fast-paced, dynamic environment.
Our Ideal Candidates will have an RN or Social Work license and:
3 years - Clinical behavioral health / substance use disorder experience required
1 year - Must be knowledgeable about community care resources and levels of behavioral health care available.
Along with:
3+ years of experience in Psychiatric and/or Substance Use treatment.
Background in Behavioral Health settings (both inpatient and outpatient).
Prior experience in Utilization Management or Managed Care.
Strong communication and presentation skills.
Ability to work autonomously and manage time effectively.
Adaptability and resilience in a rapidly changing work environment.
Why Choose Us?
This is more than a job; it's an opportunity to make a lasting difference in people's lives while leveraging your expertise in a collaborative, supportive setting.
Job Responsibilities
Assists non-clinical staff in performance of administrative reviews
Initiate referrals to ensure appropriate coordination of care.
Seek the advice of the Medical Director when appropriate, according to policy.
Performing comprehensive provider and member appeals, denial interpretation for letters, retrospective claim review, special review requests, and UM pre-certifications and appeals, utilizing medical appropriateness criteria, clinical judgement, and contractual eligibility.
Various immunizations and/or associated medical tests may be required for this position.
Job Qualifications
License
Current, active unrestricted Tennessee license in Nursing (RN) or behavioral health field (Master's level or above) (Ph.D., LCSW/LMSW, LLP, MHC, LPC, etc.) required. RN may hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law.
Experience
3 years - Clinical behavioral health / substance use disorder experience required
Skills\Certifications
Must be knowledgeable about community care resources and levels of behavioral health care available.
Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
Independent, Sound decision-making and problem-solving skills
Excellent oral and written communication skills
Strong interpersonal and organizational skills
Strong analytical skills
Positive relationship building skills and ability to engage with diverse populations
Ability to quickly identify and prioritize member needs and provide structured and focused support and interventions
Number of Openings Available
1
Worker Type:
Employee
Company:
BCBST BlueCross BlueShield of Tennessee, Inc.
Applying for this job indicates your acknowledgement and understanding of the following statements:
BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.
Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:
BCBST's EEO Policies/Notices
BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.