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  • Senior Director, Clinical Operations (TMF & CTMS)

    Summit Therapeutics Sub, Inc.

    Remote clinical services director job

    Career Opportunities with Summit Therapeutics Sub, Inc. A great place to work. Careers At Summit Therapeutics Sub, Inc. Current job opportunities are posted here as they become available. Senior Director, Clinical Operations (TMF & CTMS) Location: On-site 4 days per week at our Menlo Park, CA, Princeton, NJ or Miami, FL office. About Summit: Ivonescimab, also known as SMT112, is a novel, potential first-in-class investigational bispecific antibody combining the effects of immunotherapy via a blockade of PD-1 with the anti-angiogenesis effects associated with blocking VEGF into a single molecule. Ivonescimab displays unique cooperative binding to each of its intended targets with multifold higher affinity when in the presence of both PD-1 and VEGF. Summit has begun its clinical development of ivonescimab in non-small cell lung cancer (NSCLC), with three active Phase III trials: HARMONi is a Phase III clinical trial which intends to evaluate ivonescimab combined with chemotherapy compared to placebo plus chemotherapy in patients with EGFR-mutated, locally advanced or metastatic non-squamous NSCLC who have progressed after treatment with a 3rd generation EGFR TKI (e.g., osimertinib). HARMONi-3 is a Phase III clinical trial which is designed to evaluate ivonescimab combined with chemotherapy compared to pembrolizumab combined with chemotherapy in patients with first-line metastatic NSCLC. HARMONi-7 is a Phase III clinical trial which is intended to evaluate ivonescimab monotherapy compared to pembrolizumab monotherapy in patients with first-line metastatic NSCLC whose tumors have high PD-L1 expression. Ivonescimab is an investigational therapy that is not approved by any regulatory authority in Summit's license territories, including the United States and Europe. Ivonescimab was approved for marketing authorization in China in May 2024. Ivonescimab was granted Fast Track designation by the US Food & Drug Administration (FDA) for the HARMONi clinical trial setting. Overview of Role: The Senior Director, Clinical Operations (TMF) is a clinical research drug development expert accountable for leading and optimizing the delivery of our next generation, integrated platform for clinical trial operations and document management systems including the people, process, technology that support these functions. The individual leads transformative initiatives that create effective and efficient processes that meet high compliance standards; collaborating across Development (focus on Clinical Operations); serving as a change manager to implement new systems and practices that support the organization as we continue to grow. The Senior Director, Clinical Operations (TMF) is an effective clinical operations team leader accountable for talent acquisition, development, management, and evaluation of team members in his/her/their group. This includes responsibility for the ‘What' (delivery to performance goals) and the ‘How' (deliver consistent with Summit Therapeutics core values). The individual is also a member of the Clinical Operations extended leadership team and as such supports and influences the direction of the Clinical Operations extended team. The individual collaborates with team members to reinforce and operationalize strategic direction and solutions that support the ability to deliver on commitments to the organization and to patients. Role and Responsibilities: Develop, implement, and oversee the CTMS and TMF systems and related processes Lead the oversite of TMF and CTMS vendors, contractors, and cross-functional teams provide leadership and development to existing TMF employees and lead by example by demonstrating our core values Define, eexecute, and communicate the strategic vision for TMF and CTMS to maximize end user focus and engagement Partner with key internal and external stakeholders to remediate risks and manage emerging issues. Develop proactive approaches to process improvements and enhancements of TMF and CTMS capabilities and standards Provide business level leadership, foster best practices, and mentor and consult on TMF and CTMS across the Development and Operations organizations Lead a team of TMF and CTMs colleagues and ensure their continuous development Develop and maintain effective working relationships with stakeholder functions to achieve Clinical Operations goals Keep current on changes in industry and regulatory standards for GCP requirements and advises on business impact for TMF and CTMS Provide strategic leadership, insight, and guidance as an active member of the Clinical Operations Extended Leadership Team (XLT) Ensure inspection ready TMF and CTMS and provide expert support for audits and inspections Instill a culture of continuous improvement; acts as a change champion and effectively leads change Other key assignments including ad hoc and stretch assignments in support of Clinical Operations and clinical trial execution Travel on assignment (~25%) All other duties as assigned Experience, Education and Specialized Knowledge and Skills: Bachelor's degree (e.g. BA, BS or equivalent) required; preferably in life science; a clinical or advanced degree in a science, health related, or industry related discipline is preferred Minimum of 12+ years of strong experience with a pharmaceutical company and/or CRO with increasing levels of responsibility in Clinical Operations in a global environment (including directing platform support teams and key clinical systems such as TMF, CTMS) preferred A minimum of 5+ years of experience in people management/leadership required Proven line and functional manager experience, able to effectively lead teams including regional (multi-country) and remote-based staff Experience in Phase III execution of clinical trials; Oncology trials preferred Previous regulatory inspection experience preferred Strong comprehensive and current regulatory knowledge, including ICH Good Clinical Practice, regulations and guidelines Significant vendor oversight experience including contracts and budget management preferred The pay range for this role is $230,000-$250,000 annually. Actual compensation packages are based on several factors that are unique to each candidate, including but not limited to skill set, depth of experience, certifications, and specific work location. This may be different in other locations due to differences in the cost of labor. The total compensation package for this position may also include bonus, stock, benefits and/or other applicable variable compensation. Summit does not accept referrals from employment businesses and/or employment agencies in respect of the vacancies posted on this site. All employment businesses/agencies are required to contact Summit's Talent Acquisition team at ********************* to obtain prior written authorization before referring any candidates to Summit. #J-18808-Ljbffr
    $230k-250k yearly 4d ago
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  • Associate Medical Director

    National Staffing Solutions 4.2company rating

    Clinical services director job in Columbus, OH

    Permanent Associate Medical Director Board Certified in Family Medicine / Internal Medicine FQHC Setting What we Offer: Schedule: M- F 8am to 5pm, No Weekends Competitive Pay: $250k to $270k. depends on experience Sign On Bonus: $30,000 Full Benefits Package - Medical, dental, vision, disability & life insurance. 401(k). What the Associate Medical Director will Do: 80% Clinical / 20% Administration Supervise and coach fellow providers in how to provide excellent primary care / urgent care and community care This is a FQHC setting must be comfortable with Community Medicine Partake in leadership meeting and also act as an ambassador to community based organizations, hospitals, and payers Requirements of the Associate Medical Director: 5+ Years clinical experience / Administrative leadership experience needed Must have 2 -3 recent years experience in primary care medicine Active and unrestricted medical or nursing license in the state required Background in working for a clinic or community based inpatient setting a plus Must be ok prescribing opioids
    $250k-270k yearly 4d ago
  • Director, Medical Affairs (Remote)

    Stryker Corporation 4.7company rating

    Remote clinical services director job

    Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 114,000 colleagues serve people in more than 160 countries. Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and your family, be your true self, and live a full life. You'll also have access to: Career development with an international company where you can grow the career you dream of. Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year. An excellent retirement savings plan with high employer contribution Tuition reimbursement, the Freedom 2 Save student debt program and FreeU education benefit - an affordable and convenient path to getting a bachelor's degree A company recognized as a great place to work in dozens of countries around the world and named one of the most admired companies in the world by Fortune. A company that is recognized as one of the best big companies to work for as well as a best place to work for diversity, working mothers, female executives, and scientists. The Opportunity Abbott Heart Failure (HF) delivers devices for patients living with heart failure in the areas of hemodynamic monitoring and mechanical circulatory support. Medical affairs of Abbott HF is seeking to hire a director who will join a team of medical specialist dedicated to all medical aspects of safe and effective device heart failure treatment. The director will report to the Chief Medical Officer. The Director of Medical Affairs will provide daily business operations support related to product development and clinical research, product quality, compliance, commercial/marketing activities and customer interactions. The director assists the Chief Medical Officer in being medical representative of Abbott HF to external regulatory agencies and professional societies. What You'll Work On The Medical Director Develops medical opinions, medical platform documents and Health Hazard Assessments. Provides medical input for promotional and commercial activities as requested. Serves as medical representative on Risk Evaluation teams. Assists investigation teams by providing medical input as needed. Responsible for updating medical affairs procedural documents and submitting change requests when needed. Provides medical support for MDR reporting when needed. Provides initial medical input for quality/regulatory customer communications, technical bulletins and quality directives. Engages with direct customer interactions with medical content as needed. Regionally responsible for Investigator Initiated Study and Research Grant programs. Provides input or content to professional education activities. Responsible for engaging in and documenting off-label discussions. Assists the Chief Medical Officer in KOL and professional society engagement. Provides medical input to new product development An MD is strongly preferred for this role, but a PhD in a relevant area would be considered. A minimum of 5 years of clinical experience including in CV medicine would be clinical research, including interpretation and presentation would be expected. Strong presentation skills required. The role is remote (US-based) Up to 70 % travel should be expected. APPLY NOW Enjoy a competitive base salary plus exciting bonus opportunities and long-term incentives designed to recognize your success. Learn more about our health and wellness benefits, which provide the security to help you and your family live full lives: ********************** Follow your career aspirations to Abbott for diverse opportunities with a company that can help you build your future and live your best life. Abbott is an Equal Opportunity Employer, committed to employee diversity. Connect with us at *************** on Facebook at *********************** and on Twitter @AbbottNews and @AbbottGlobal #J-18808-Ljbffr
    $221k-314k yearly est. 5d ago
  • Remote Liver Medical Affairs Director - Regional Expert

    Gilead Sciences, Inc. 4.5company rating

    Remote clinical services director job

    A leading biopharmaceutical company is seeking a Senior Director for Medical Affairs to lead initiatives focused on liver diseases. The ideal candidate should have substantial clinical experience in hepatology and a commitment to scientific excellence. This remote position requires strategic collaboration and contributions to research efforts to improve liver care outcomes. Strong leadership and communication skills are essential for engaging diverse healthcare professionals in clinical discussions. #J-18808-Ljbffr
    $235k-330k yearly est. 1d ago
  • Global insurance Clinical Care Manager - Bilingual Japanese RN - Remote

    Unitedhealth Group 4.6company rating

    Remote clinical services director job

    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together The Global insurance Clinical Care Manager - Bilingual Japanese RN will perform prospective, concurrent, and retrospective reviews and non-urgent travel requests for Global Expat members located outside the United States. This is a 24/7 operation, and while your primary schedule will follow the hours listed above, occasional flexibility may be required to support members in Japan. You may need to adjust your schedule to accommodate their time zone, which could include early mornings, late nights, or weekends as business needs arise. These instances are rare and typically involve completing member outreach and any associated case review and documentation. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. This position supports the Eastern time zone (EST) which is 3:00pm-11:00 pm. If you reside in Central time zone (CST) hours would be 2:00pm-10:00pm for Mountain time zone (MST) hours would be 1:00pm-9:00pm, for Pacific time zone (PST) hours are 12:00pm-8:00pm. Monday- Friday with potential to work limited overnight and/or weekend hours based on client or member needs. Primary Responsibilities: A GI CCM must consider both US and international care standards and regulatory guidelines. They must be able to work in multiple platforms and comfortable communicating with members and providers to obtain information needed to perform the clinical review Must also be willing to be cross trained to assist Clinical Health Managers in pre-admission and post-discharge member outreaches The clinical team is also involved in fraud investigations, identifying multiple fraudulent clients and claims You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Registered Nurse with an active unrestricted United States license Must be bilingual in Japanese and English, with strong verbal and written communication skills 3+ years of experience in medical-surgical inpatient acute care Experience with working in collaboration with Medical Director to review care plans make recommendations. Ability to advocate on behalf of the member's needs while considering contractual limitations Proven experience in Clinical Coverage Review, Medical Claim Review or Clinical Appeals Proven communication skills at all levels Proven ability to be flexible and display a positive attitude Proven solid problem-solving, organizational and crisis management skills Proven ability to function confidently and efficiently in fast paced work environment Proven ability to foster team cohesion in an international virtual environment Proven ability to provide empathetic and courteous service while working effectively with co-workers face-to-face or remotely in dynamic and emergent situations Demonstrated cultural competence and awareness of the challenges of healthcare delivery in the global arena and the potential impact on the health and safety of expatriates, business travelers and UHC Global members Proven advanced software skills with ability to work in multiple platforms with clinical case reviews Proven advanced skills with Microsoft Office - Excel, Word Ability to work in the Eastern time zone (EST) which is 3:00pm-11:00 pm. If you reside in Central time zone (CST) hours would be 2:00pm-10:00pm for Mountain time zone (MST) hours would be 1:00pm-9:00pm, for Pacific time zone (PST) hours are 12:00pm-8:00pm. Monday- Friday with potential to work limited overnight and/or weekend hours based on client or member needs Preferred Qualifications: Bachelor's degree 2+ years of experience in utilization management or case management in a managed care or hospital environment Experience in international healthcare and/or air medical transport Experience in discharge planning and/or chart review International travel experience Demonstrated familiarity with InterQual criteria guidelines *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $72.8k-130k yearly 2d ago
  • Bilingual Behavioral Health Care Manager

    Heritage Health Network 3.9company rating

    Remote clinical services director job

    This role works closely with Care Team Operations, Clinical Operations, Behavioral Health clinicians (LMFT/LCSW/LPCC), Community Health Workers (CHWs), Compliance, Finance (for authorizations), Care Operations Associates, and external partners including hospitals, primary care providers, behavioral health agencies, housing providers, and community-based organizations. Responsibilities Serve as the primary point of contact for assigned members with behavioral health and psychosocial complexity, building trust through consistent, trauma-informed engagement. Conduct comprehensive, holistic assessments addressing behavioral health, substance use, functional status, social determinants of health, safety risks, and care gaps. Develop, implement, and maintain person-centered care plans that integrate behavioral, medical, and social goals; update plans following transitions of care or changes in condition. Coordinate services across the continuum of care, including behavioral health providers, primary care, hospitals, housing supports, transportation, social services, and community-based organizations. Conduct required in-person home or community visits based on acuity, risk stratification, and payer requirements. Support Transitions of Care (TOCs) by completing timely follow-up, coordinating post-discharge services, and reinforcing discharge instructions and medication understanding. Utilize motivational interviewing, behavioral coaching, and health education to promote engagement, adherence, self-management, and long-term member stability. Identify, escalate, and address behavioral health risks, safety concerns, service delays, benefit lapses, and environmental barriers using HHN escalation protocols. Coordinate and track referrals, appointments, transportation, and follow-ups to ensure continuity and timeliness of care. Maintain accurate, timely, and audit-ready documentation of all assessments, encounters, and interventions in eClinicalWorks (ECW) and other HHN systems. Meet or exceed HHN and health plan productivity standards, including outreach cadence, encounter requirements, documentation timeliness, TOC completion, and quality measures. Actively participate in multidisciplinary case reviews, care conferences, team huddles, and escalations with nurses, behavioral health clinicians, CHWs, care operations, and compliance. Assist members with plan navigation, eligibility redeterminations, social service applications, housing resources, and crisis intervention support. Communicate professionally with members and care partners using HHN-approved channels, including phone, RingCentral, secure messaging, and SMS workflows. Contribute to continuous quality improvement efforts by identifying workflow gaps, documenting barriers, and sharing insights to improve care delivery. Uphold confidentiality and comply with all HIPAA, Medi-Cal, ECM, and payer regulatory requirements. Remain flexible and responsive to member needs, including field-based work and engagement in community settings. Skills Required Bilingual (English/Spanish) proficiency required to support member engagement and care coordination. Strong ability to build rapport and trust with diverse, high-need member populations. Proficiency in using eClinicalWorks (ECW), Google Suite (Docs, Sheets, Drive), RingCentral, and virtual communication tools. Ability to interpret and use PowerBI dashboards, reporting tools, and payer portals. Demonstrated skill in conducting holistic assessments and developing person-centered care plans. Experience with motivational interviewing, trauma-informed care, or health coaching. Strong organizational and time-management skills, with the ability to manage a complex caseload. Excellent written and verbal communication skills across in-person, telephonic, and digital channels. Ability to work independently, make sound decisions, and escalate appropriately. Knowledge of Medi-Cal, SDOH, community resources, and social service navigation. High attention to detail and commitment to accurate, audit-ready documentation. Ability to remain calm, patient, and professional while supporting members facing instability or crisis. Comfortable with field-based work, home visits, and interacting in diverse community environments. Cultural humility and demonstrated ability to work effectively across populations with varied lived experiences. Competencies Member Advocacy: Champions member needs with urgency and integrity. Operational Effectiveness: Executes workflows consistently and flags process gaps. Interpersonal Effectiveness: Builds rapport with diverse populations. Collaboration: Works effectively within an interdisciplinary care model. Decision Making: Uses judgment to escalate or intervene appropriately. Problem Solving: Identifies issues and creates practical, timely solutions. Adaptability: Thrives in a fast-growing, startup-style environment with evolving processes. Cultural Competence: Engages members with respect for their lived experiences. Documentation Excellence: Produces accurate, timely, audit-ready notes every time. Strong empathy, cultural competence, and commitment to providing individualized care. Ability to work effectively within a multidisciplinary team environment. Exceptional interpersonal and communication skills, with a focus on building trust and rapport with diverse populations. Job Requirements Education: Bachelor's degree in Social Work, Psychology, Public Health, Human Services, or related field. Licensure: Licensed LMFT, LCSW, LPCC.; certification in care coordination or CHW training is a plus. Experience: 1-3 years of care management or case management experience, preferably with high-need Medi-Cal populations. Experience in community-based work, homelessness services, behavioral health, or SUD settings strongly preferred. Familiarity with Medi-Cal, ECM, and community resource navigation. Travel Requirements: Regular travel for in-person home or community visits (up to 45%). Physical Requirements: Ability to perform home visits, climb stairs, sit/stand for prolonged periods, and lift up to 20 lbs if needed.
    $61k-76k yearly est. 19h ago
  • CCO In Training, Director of Clinical Services

    Pennant Group

    Remote clinical services director job

    This opportunity will be on-site in Arizona, Nevada, Utah or Colorado. 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 12d ago
  • Director, Clinical Care Services - New Mexico, Remote

    Magellan Health 4.8company rating

    Remote clinical services director 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 10d ago
  • Medical Practice Manager (Remote)

    Tembo Health

    Remote clinical services director job

    ABOUT THE COMPANY Tembo Health is a virtual medical practice that helps patients in nursing homes receive care in hard to access specialties like psychiatry and cardiology. Our mission is to improve healthcare outcomes. The status quo is unacceptable, as our seniors have difficulty receiving specialty care leading to worse healthcare outcomes including re-hospitalizations. By partnering with nursing homes, Tembo Health drives quality improvement with our network of world-class clinicians. Our technology allows our clinicians to provide both complex and quality care with a seamless user experience integrating medical data from various sources. Our leadership team has deep expertise in clinical medicine, clinical transformation, operations, and technology with experience at top institutions including BCG, GE, Harvard Hospitals, Mount Sinai, Northwell Health, and Oscar. We're backed by prominent investors including Bloomberg Beta, B Capital Group, and Resolute Ventures. We've proven product market fit over the past two years, have customer traction in NY, TX, and MI, and are scaling upon our success. In other words, it's a great time to get in on the ground floor! ABOUT THE ROLE We're looking for a Practice Manager to assist us with our growing clinical team. Responsibilities. Manage day-to-day clinical operations. You'll be asked to coordinate and execute all non-clinical aspects of patient care, starting with patient registration through appointment note sharing through claim followup/ Implement and refine billing and credentialing You'll contract with the major payor and enroll new providers. You'll submit claims, research superior billing methods, and more. Develop tools that improve the work of all team members. You'll leverage Athena, Google Suite and other tools to directly build tools that will help the team with things like tracking project progress. You'll also lend your insight to the Engineering team to build tools for clinicians and others within our EMR. Sample Work Plan With in the first week, you'll own and manage day-to-day clinical operations with activities like patient registration preauthorizations claim submission claim followup Within the first month, you'll have used your experience to get us working more efficiently than most offices with activities like cleaning up our billing processes instituting a plan for credentialing Within first three months, you'll use your management skills make sure our operations can serve our quickly scaling company through activities like owning contracting and onboarding processes for providers owning onboarding processes for facilities Within 6 months, you'll use you problem solving skills and innovation develop best in class procedures across the company implement high levels of automation within the EMR serve as subject matter expert with Engineering team to build tools for the clinical and account management teams ABOUT YOU Qualifications. You'll be successful in this role if You know the Athena EMR You strive to make things efficient You love the challenge of figuring out something new You're not afraid to pick up the phone You keep great notes You've worked in or managed a medical practice or similar Suggested Requirements. The following experiences are suggested but not required: You've worked on large or growing teams Experience with national provider contracts
    $99k-166k yearly est. 7d ago
  • Manager, Clinical Operations - Full Service CRA Line Manager (Home-Based in Western US )

    Syneos Health Clinical Lab

    Remote clinical services director 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.
    $60k-90k yearly est. Auto-Apply 11d ago
  • Manager, Clinical Operations - Full Service CRA Line Manager (Home-Based in Western US )

    Syneos Health, Inc.

    Remote clinical services director 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. 10d ago
  • Program Manager, Clinical Tools

    Habitat Health

    Remote clinical services director job

    At Habitat Health, we envision a world where older adults experience an independent and joyful aging journey in the comfort of their homes, enabled by access to comprehensive health care. Habitat Health provides personalized, coordinated clinical and social care as well as health plan coverage through the Program of All-Inclusive Care for the Elderly (“PACE”) in collaboration with our leading healthcare partners, including Kaiser Permanente. Habitat Health offers a fully integrated experience that brings more good days and a sense of belonging to participants and their caregivers. We build engaged, fulfilled care teams to deliver personalized care in our centers and in the home. And we support our partners with scalable solutions to meet the health care needs and costs of aging populations. Habitat Health is growing, and we're looking for new team members who wish to join our mission of redefining aging in place. To learn more, visit ****************************** Role Scope: We are looking for a program manager to drive our Clinical and Strategic tools portfolio, specifically EMR and Growth engines. As a Program Manager you will work cross-departmentally to organize project planning, implementation, and training success. We are looking for a highly organized and dynamic individual who can juggle multiple projects across various applications; help implement and refine processes for intake, prioritization, and tracking of both projects and regular maintenance requests; and work closely with Platform and Operations leaders on end user training success. Serve as the primary program manager for Epic clinical tools for our PACE program (e.g., assessments, care plans, day center management), coordinating enhancements, upgrades, and cross-functional initiatives Design, implement, and continuously improve intake, prioritization, and tracking mechanisms for clinical tool projects, enhancements, and ongoing maintenance Build and drive a robust program for clinical tools: roadmap planning, status reporting, risk management, and dependency tracking Translate ambiguous clinical and operational needs into clear project scope, requirements, and execution plans Partner closely with PACE Center leadership, Office of the CMO, Population Health, Practice Operations, Finance, Strategy, Growth, and Health Plan Operations to understand priorities and align work accordingly Facilitate working sessions and decision forums with both senior leadership and frontline staff, ensuring clarity, alignment, and forward momentum and identify and fill gaps in end-user trainings Drive refinement of documentation and facilitate demos or training sessions to support adoption and workflow optimization Support limited Salesforce-related initiatives tied to growth, referral workflows, or operational visibility, partnering closely with internal Platform and Data teams Coordinate with Epic, Salesforce, and other third-party vendors to drive timely delivery, clarify system capabilities, and ensure appropriate documentation is collected and shared Qualifications 7+ years of experience managing cross-functional technology or clinical application programs, ideally in healthcare Hands-on experience working with Epic clinical applications (e.g., Ambulatory); familiarity with how clinical workflows operate within Epic Strong ability to bring structure to ambiguity, define scope, and create executable plans from evolving business needs Excellent communication and facilitation skills, with comfort engaging both executive leadership and frontline users Strong documentation skills, including project plans, process flows, and executive-level summaries Proficiency with Microsoft Office tools (Excel, PowerPoint) and visualization tools (e.g., Lucid, Visio) Nice to Have Experience with Salesforce Experience with Agile methodology including leading SCRUM PACE, Medicare/Medicaid, or highly regulated healthcare environments experience Compensation: We take into account an individual's qualifications, skillset, and experience in determining final salary. This role is eligible for medical/dental/vision insurance, short and long-term disability, life insurance, flexible spending accounts, 401(k) savings, paid time off, and company-paid holidays. The expected salary range for this position is $117,000 -$130,000 and is bonus eligible. The actual offer will be at the company's sole discretion and determined by relevant business considerations, including the final candidate's qualifications, years of experience, skillset, and geographic location. Vaccination Policy, including COVID-19 At Habitat Health, we aim to provide safe and high-quality care to our participants. To achieve this, please note that we have vaccination policies to keep both our team members and participants safe. For covid and flu, we require either proof of vaccination or declination form and required masking while in participant locations as a safe as and essential requirement of this role. Requests for reasonable accommodations due to an applicant's disability or sincerely held religious beliefs will be considered and may be granted based upon review. We also require that team members adhere to all infection control, PPE standards and vaccination requirements related to specific roles and locations as a condition of employment. Our Commitment to Diversity, Equity, and Inclusion: Habitat Health is an Equal Opportunity employer and is committed to creating a diverse and inclusive workplace. Habitat Health applicants are considered solely based on their qualifications, without regard to race, color, religion, creed, sex, gender (including pregnancy, childbirth, breastfeeding or related medical conditions), gender identity, gender expression, sexual orientation, marital status, military or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), or other status protected by applicable law. Habitat Health is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Habitat Health will take steps to provide people with disabilities and sincerely held religious beliefs with reasonable accommodations in accordance with applicable law. Accordingly, if you require a reasonable accommodation to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact us at *************************. Beware of Scams and Fraud Please ensure your application is being submitted through a Habitat Health sponsored site only. Our emails will come from @habitathealth.com email addresses. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission by selecting the ‘Rip-offs and Imposter Scams' option: *******************************
    $117k-130k yearly Auto-Apply 26d ago
  • Manager, Clinical Services

    Allied Benefit Systems 4.2company rating

    Remote clinical services director 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. 7d ago
  • Senior Clinical Program Manager

    Histosonics 3.6company rating

    Remote clinical services director 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 Senior Clinical Program Manager (Sr. 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 Sr. 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 3-5 years clinical trial management experience; IDE trial experience REQUIRED. Minimum of 8 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. Auto-Apply 58d ago
  • Clinical Program Manager - CMS Medical Review (RVC)

    Broadway Ventures 4.2company rating

    Remote clinical services director 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 47d ago
  • Clinical Program Manager RN - Full-time - REMOTE

    Providence Health & Services 4.2company rating

    Remote clinical services director 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 2d ago
  • Clinical Program Manager, HSPRS

    Equal Opportunity Employer: IRC

    Remote clinical services director 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 27d ago
  • Director of Clinical Services

    Newvista Behavioral Health 4.3company rating

    Clinical services director job in Columbus, OH

    Job Address: 10270 Blacklick - Eastern Road NW Pickerington, OH 43147 Role: Director of Clinical Services Job Post Title: Director of Clinical Services Solero Behavioral Transitions We provide a safe and supportive environment for individuals struggling with severe mental illness. Our program offers comprehensive care, including individual and group therapy sessions, case management services and life skills training. A mental health residential facility is a place where people receive intensive, specialized care for mental health and or substance abuse issues in a non-hospital setting. Residents receive 24-hour supervision, treatment, and support from mental health experts. The environment is homelike and supportive, and residents participate in therapeutic activities. Shift: M-F, with a weekend rotation Hours: 8-4:30 Perks at Work Healthcare: Medical Packages with Rx - 3 Choices Flexible Spending Accounts (FSA) Dependent Day Care Spending Accounts Health Spending Accounts (HSA) with a company match Dental Care Program - 2 choices Vision Plan Life Insurance Options Accidental Insurances Paid Time Off + Paid Holidays Employee Assistance Programs 401k with a Company Match Education + Leadership Development Up to $15,000 in Tuition Reimbursements Student Loan Forgiveness Programs Approved HRSA Site Approved STAR-LRP Site The Role Itself License/Education/Certification: Formal education program or training in Quality Improvement/Risk Management/Compliance for inpatient or behavioral health settings. Familiarity with healthcare laws, regulations, accreditation standards, state licensure or certification and Best Practices in healthcare compliance program implementation Knowledge of the principals of The Joint Commission and must be well versed in CMS guidelines Knowledge and understanding of the Regulatory Compliance Ohio Department of Mental Health and Addictions Serves as resource for faculty regarding medical record content and regulatory requirements Ability to adapt to change and work under stressful situation Education: Masters degree in social work with LSW and documented experience in group therapy setting. Counselor Degree Must be 21 yrs or older Top of Form License: LSW, LISW, LPC, LPCC, MFT, LMFT Current unencumbered clinical license per state of practice guidelines. Levels of Care Residential Mental Health Services A service activity which uses clinical and medical interventions, including the administration of physician prescribed medications and clinical monitoring, to help stabilize mental health symptoms to for individuals requiring a more structured and supervised environment. Partial Hospitalization Program Comprehensive Mental Health program with intensive treatment services to help individuals prepare for re-entry into all aspects of their lives including home, work, school and relationships. Program Purpose: We are committed to producing the highest level of clinical outcomes for clients and their families. Solero Behavioral Transitions is a trauma-informed, non-coercive treatment program designed to treat individuals struggling with Mental Health symptoms. The Solero's focused mental health rehabilitation includes; Building Resiliency Optimistic outlook Locus of control Sense of self Ability to bounce back Change management Practical Life Skills Problem-solving Money management Time management Personal change Self-awareness Communication Skills Active listening Nonverbal communication Communication skills Social Radar Negotiation skills These are the core concepts that extend into many areas of a client's life and help develop the foundations for recovery and recovery sustainability.
    $62k-83k yearly est. Auto-Apply 54d ago
  • Manager, Advisory Services, Community Health

    Premier Healthcare Solutions 4.4company rating

    Remote clinical services director job

    Advance public health impact with data, strategy and execution. Premier's Community Health Advisory Team helps state agencies and health leaders modernize systems, strengthen equity and turn policy into measurable performance through analytics, collaboration and hands-on expertise. What will you be doing: The Manager works collaboratively within a team of highly qualified Advisory consultants to deliver performance improvement to healthcare systems. This position will be primarily responsible for performing billable work for clients. The role of the Manager is to actively lead and manage a significant workstream or project. Responsibilities include determining client needs in terms of the engagement statement of work; lead, guide, complete and provide quality assurance over data analyses; interpret data analyses and form initial recommendations; develop final recommendations and solutions for client consideration; develop deliverables and presentations materials for various audiences; assist in the implementation of recommended improvements; assist and manage risk and issues with project leadership; manage project or workstream economics and project administrative activities and logistics. The Manager participates and oversees all aspects of the workstream, or project assigned. They are responsible for the day-to-day management of all activities and staff assigned to their workstream or project. The Manager works in a team environment to provide input, guidance, and quality assurance to team deliverables and presentations during each phase of a project. The Manager will provide mentorship and guidance to all staff working with them on projects. The Manager is responsible for building strong, referenceable client relationships. The Manager is required to also participate in Premier internal activities including practice development, required, and approved educational opportunities throughout the year and learning the various technologies Premier offers to its clients. Additionally, the Manager should: • Maintain utilization targets for client billable projects • Create value through meaningful client relationship management, solution development and implementation delivery • Create a positive team environment by enriching staff skills and knowledge and creating a productive and collaborative environment • Create value for the Advisory practice through meaningful participation in practice related activities aimed at growing and enriching the Practice as a whole or individual Service Lines within the Practice Key Responsibilities Responsibility #1- 60% • Execute/direct/oversee data analyses, initiate interpretations, and conclusions, and prepare verbal and graphic presentations, using methods that are professionally sound and efficient relative to project objectives and conform to standards. Perform quality assurance on project deliverables. • Assist in determining client needs by effectively leading client interviews and utilizing various tools and analytical methods. Summarize analytical findings in a coherent manner and draws insight from observations, interviews, and data analyses. Develops accurate conclusions from findings. Draft's recommendations and potential solutions for team leadership review. Develops final recommendations and solutions for client review. • Effectively execute on project plans in accordance with engagement statements of work and to client satisfaction. • Develop presentations and deliverables for client audiences that communicate strategy and outcomes. • Generate billings revenue by conducting assigned analyses, write and prepare reports, and assist clients in implementing desired changes. • Guide and lead project management related activities for assigned projects. • Manage the budget and expenses for their assigned projects and manage project profitability. • Manage staff assigned to their projects including providing mentoring and education for staff. • Participate in risk and issue identification and mitigation along with the project leadership team. Responsibility #2 - 15% • Participate in practice development activities for the Advisory Services Practice overall or for the Service Lines within the Practice. Responsibility #3 - 10% Learn Premier based technologies and services. Responsibility #4 - 10% • Actively listen for market opportunities on current engagements and collaborative networks and communicates potential leads to managers. • Contribute to the development of sales presentation deliverables using prescribed formats and technology; proactively seeks out opportunities to participate. • Identifies opportunities to improve profitability Responsibility #5 - 5% Complete all required training requirements on an annual basis. Required Qualifications Work Experience: Years of Applicable Experience - 5 or more years Education: Bachelors (Required) Preferred Qualifications Skills: • Coordinate and deliver effective presentations (verbal and written) to client audiences to communicate project outcomes, recommendations, and strategy • Ability to conduct analyses, oversee, and mentor others in the delivery and production of client deliverables • Ability to relate to clients and team members in an effective and collaborative manner • Ability to lead work groups to successful outcomes Experience: • Experience in Health Systems Finance, Operations (clinical, support or operations), Operational or Strategic Consulting, Strategic Planning or Decision Support Analytics • Experience leading cross-functional teams Education: Master's Degree; RN license or other professional license in clinical area of expertise; PMP/Lean Certification This is a remote position and requires up to 75% travel. Additional Job Requirements: Remain in a stationary position for prolonged periods of time Be adaptive and change priorities quickly; meet deadlines Attention to detail Operate computer programs and software Ability to communicate effectively with audiences in person and in electronic formats. Day-to-day contact with others (co-workers and/or the public) Making independent decisions Ability to work in a collaborative business environment in close quarters with peers and varying interruptions Working Conditions: Remote Travel Requirements: Travel 61-80% within the US Physical Demands: Sedentary: Exerting up to 10 pounds of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves remaining stationary most of the time. Jobs are sedentary if movement is required only occasionally, and all other sedentary criteria are met. Premier's compensation philosophy is to ensure that compensation is reasonable, equitable, and competitive in order to attract and retain talented and highly skilled employees. Premier's internal salary range for this role is $113,000 - $188,000. Final salary is dependent upon several market factors including, but not limited to, departmental budgets, internal equity, education, unique skills/experience, and geographic location. Premier utilizes a wide-range salary structure to allow base salary flexibility within our ranges. Employees also receive access to the following benefits: · Health, dental, vision, life and disability insurance · 401k retirement program · Paid time off · Participation in Premier's employee incentive plans · Tuition reimbursement and professional development opportunities Premier at a glance: Ranked #1 on Charlotte's Healthiest Employers list for 2019, 2020, 2022, and 2023 and 21st Healthiest Employer in America (2023) Named one of the World's Most Ethical Companies by Ethisphere Institute for the 16th year in a row Modern Healthcare Best in Business Awards: Consultant - Healthcare Management (2024) The only company to be recognized by KLAS twice for Overall Healthcare Management Consulting For a listing of all of our awards, please visit the Awards and Recognition section on our company website. Employees receive: Perks and discounts Access to on-site and online exercise classes Premier is looking for smart, agile individuals like you to help us transform the healthcare industry. Here you will find critical thinkers who have the freedom to make an impact. Colleagues who share your thirst to learn more and do things better. Teammates committed to improving the health of a nation. See why incredible challenges require incredible people. Premier is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to unlawful discrimination because of their age, race, color, religion, national origin, ancestry, citizenship status, sex, sexual orientation, gender identity, gender expression, marital status, familial status, pregnancy status, genetic information, status as a victim of domestic violence, covered military or protected veteran status (e.g., status as a Vietnam Era veteran, disabled veteran, special disabled veteran, Armed Forces Serviced Medal veteran, recently separated veteran, or other protected veteran) disability, or any other applicable federal, state or local protected class, trait or status or that of persons with whom an applicant associates. We also consider qualified applicants with criminal histories, consistent with applicable federal, state and local law. In addition, as a federal contractor, Premier complies with government regulations, including affirmative action responsibilities, where they apply. EEO / AA / Disabled / Protected Veteran Employer. Premier also provides reasonable accommodations to qualified individuals with a disability or those who have a sincerely held religious belief. If you need assistance in the application process, please reply to diversity_and_accommodations@premierinc.com or contact Premier Recruiting at ************. Information collected and processed as part of any job application you choose to submit to Premier is subject to Premier's .
    $57k-79k yearly est. Auto-Apply 28d ago
  • Manager Clinical Staff and Operation (100% Full Time, Days)- Cardiovascular Surgery Services

    Adena Health 4.8company rating

    Clinical services director job in Chillicothe, OH

    The Clinic Manager II assumes primary responsibility for overseeing clinical and administrative functions of capital and operating budgets, patient registration, billing, clinical information systems, management of clinical and administrative staff and clinic marketing and planning. This position is responsible for managing performance for Caregiver Engagement, Service Excellence, Quality & Safety and Stewardship. Responsible for multiple small practices or a large complex practice with a score between 7 and 12 on the Manger Trigger Tool (see below). This position ensures compliance with all regulatory and accreditation standards, financial performance and clinic policies. Decisions are made independently or in collaboration with others. This position has patient contact, has access to confidential information and functions under the direct supervision of a Director. Minimum Qualifications: Required Educational Degree: Bachelor's Degree Major/Area of Concentration: Any Effective 01/01/2021 for all current Managers and New Hires Bachelor's degree required within 5 yrs (3 yrs if you already posses an Associate's degree) Preferred Education: Bachelor's Degree in Business Administration or related field preferred Required Certifications, Credentials and Licenses: De-escalation training within 6 months. Required Experience: 2 - 4 years of practice management experience with progressive responsibility Job Specific Essential Functions: Provide operational leadership and oversight of one or more high-volume or multi-specialty clinics. Participate in recruitment, hiring, onboarding, training, and professional development of staff. Direct, supervise, and evaluate performance of clinical and administrative staff. Partners with hospital leaders to oversee outpatient ancillary operations, when applicable. Engage physicians and staff through communication of priorities, delegation of clinic tasks, and accountability to the achievement of goals. Utilize huddles and rounding to facilitate problem solving, communication from AHS system meetings, and identification of clinic concerns/issues. Manage processes in the clinic through implementation of SOP's, auditing, correction and suggestions for continuous quality improvement. Develop plans for improved provider productivity by working with providers on waste elimination, template redesign, optimization of outrotations, improving fill rate, and marketing / sales interfaces where appropriate. Responsible for metric tracking, root cause analysis, and improvement to meet or exceed budgeted quality, service, volumes and expenses. Ensure all provider encounters are captured, documented, locked in a timely manner and coded for comprehensive revenue cycle process. Responsible for completion of cash posting, financial deposits, A/R tracking and improvement toward MGMA service specific days in A/R and reporting of variances Act as liaison for providers to answer questions, communicate concerns to system, and solve day to day issues. Holds clinic team accountable for adherence to leadership and provider compact expectations of communication / behavior in delivery of care for optimal service to patients. Adhere to AHS, local, state and national legal and regulatory compliance requirements through ongoing clinic audit reviews and corrective action Benefits for Eligible Caregivers: Paid Time Off Retirement Plan Medical Insurance Tuition Reimbursement Work-Life Balance About Adena Heart and Vascular: The Adena Heart and Vascular Institute provides advanced, comprehensive care for heart, vascular, and thoracic conditions through cutting-edge technology and a skilled team of specialists. The institute emphasizes personalized treatment plans, collaboration among experts, and a focus on both immediate and long-term health. A key feature is our new hybrid operating room, which integrates advanced imaging and surgical capabilities to perform complex, minimally invasive cardiovascular procedures-such as TEVAR and EVAR-with a multidisciplinary team. This approach reduces complications and recovery times, allowing patients to receive high-quality, innovative care close to home. About Adena Health: Adena Health is an independent, not-for-profit and locally governed health organization that has been “called to serve our communities” for more than 125 years. With hospitals in Chillicothe, Greenfield, Washington Court House, and Waverly, Adena serves more than 400,000 residents in south central and southern Ohio through its network of more than 40 locations, composed of 4,500 employees - including more than 200 physician partners and 150 advanced practice provider partners - regional health centers, emergency and urgent care, and primary and specialty care practices. A regional economic catalyst, Adena's specialty services include orthopedics and sports medicine, heart and vascular care, pediatric and women's health, oncology services, and various other specialties. Adena Health is made up of 341 beds, including 266-bed Adena Regional Medical Center in Chillicothe and three 25-bed critical access hospitals-Adena Fayette Medical Center in Washington Court House; Adena Greenfield Medical Center in Greenfield; and Adena Pike Medical Center in Waverly.
    $61k-75k yearly est. Auto-Apply 59d ago

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