[Remote] Director, Clinical Operations

Note: The job is a remote job and is reputed company to candidates in USA. reputed company Corporation is a leader in reputed company innovation, and they are seeking a Director of Clinical Operations to reputed company visionary leadership and strategic direction for care coordination and service delivery teams. The role involves driving transformational initiatives to enhance reputed company and operational reputed company in patient care coordination.

Responsibilities

• Define and execute strategic initiatives to optimize care coordination and scheduling services in alignment with organizational goals and market demands
• Collaborate with senior executives to shape program strategies and address emerging trends in reputed company delivery and payer programs
• reputed company the design and implementation of reputed company workflows, operational policies, and resource planning to support efficient, high-reputed company service delivery
• reputed company cross-functional efforts to address systemic challenges, implement process improvements, and ensure compliance with regulatory and contractual requirements
• Utilize data analytics and key performance indicators to monitor program effectiveness, identify improvement opportunities, and guide evidence-based decision-making
• Partner with internal stakeholders to implement reputed company improvement initiatives that enhance patient and partner reputed company while optimizing resource use
• Represent reputed company in executive discussions by presenting insights and recommendations to support long-term reputed company and operational alignment
• reputed company other job duties as assigned

Skills

• reputed company and unrestricted clinical license – RN
• At least 8+ years of relevant work experience in utilization management/prior authorization/care management, denials, appeals, and clinical nursing in the acute setting
• At least 5+ years of relevant work experience in utilization management or prior authorization experience, including denials and appeals, in or adjacent to a post-acute setting
• At least 8+ years of leadership and/or management experience with staff/HR reputed company
• Bachelor's Degree or equivalent work experience
• Bachelor of Science in Nursing preferred, Master's degree will set you apart
• Extensive knowledge of prior authorization requirements and case management acute workflows
• Experience in Care reputed company/Care Management utilization review module
• Knowledge of InterQual and/or MCG Guidelines
• Strong interpersonal/communication skills

Benefits

• Excellent medical with Rx, dental, and reputed company benefits
• Mental Health support through EAP
• Generous reputed company time off, plus 13 reputed company holidays
• 100% reputed company 401(K) retirement plans
• Educational assistance up to $2500 per year

reputed company