Job Information
KEPRO Clinical Operations Manager (Full Time) Hybrid Must Reside in West Virginia in Charleston, West Virginia
CNSI and Kepro are now Acentra Health! Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.
Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the company’s mission, actively engage in problem-solving, and take ownership of your work daily. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.
Job Summary
As a Clinical Operations Manager, you will lead the charge in overseeing Clinical Operations, including Utilization Management, and Case Management functions for Medical and Behavioral Health Services. This pivotal role encompasses a multifaceted approach, involving the development and enforcement of operational policies and procedures. Demonstrated experienced with staff supervision and development, establish and oversee Physicians Contractors, as part of medical necessity review processes. You will be closely involved with State Contractors and Program Stakeholders. Embrace the opportunity to drive efficiency in healthcare operations, making a tangible impact on the quality of care provided and the overall success of the organization.
Job Responsibilities
Coordinate and direct Clinical Operations and associated programs, while directly supervising clinical support staff to ensure optimal performance and adherence to established protocols.
Develop and maintain robust procedures and practices to effectively achieve departmental or program goals and objectives, fostering a culture of continuous improvement and excellence.
Adept at managing stakeholder and physician relationships while ensuring compliance with programs and policies.
Monitor key business and financial metrics pertinent to daily operational success, reporting progress and assessing performance through regular reviews to drive strategic decision-making.
Take charge of clinical operations, including program coordination, scheduling, work plan management, reporting, and issue resolution tracking, ensuring smooth and efficient workflows.
Demonstrate leadership and sound decision-making abilities to maintain continuity and operational effectiveness.
Proactively address program or departmental operations issues, either resolving them directly or delegating to appropriate personnel for prompt and effective resolution, fostering a culture of accountability and problem-solving.
Required Qualifications and Experience
Bachelor’s degree and a minimum of 5 years of relevant experience, or an equivalent combination of education and experience.
Active unrestricted RN license in the State of West Virginia as per contract requirements.
Minimum of 3 to 5 years of management experience in a health care setting.
Case Management Certification is preferred.
5 years of clinical experience, with a focus on utilization review for at least 3 years, demonstrated expertise in optimizing resource allocation and quality of care.
Minimum of 1 year of experience performing quality audits, evaluating processes, and developing improvement plans.
Proficiency in navigating and effectively contributing within the company’s decision-making and organizational structure.
Manage a Physician Consultants Review Panel through criteria development for all review areas when deemed neccessary. Execute and maintain physician contracts with Corporate, hold Physician quarterly meetings, IRR Physician activities and act as a liaison with corporate for Physician credentialing.
Provide Physician training on systems usage and corporate compliance.
Skilled in evaluating and refining operational procedures, policy formulation, and implementing innovative strategies to enhance efficiency and effectiveness.
Proven track record in employee development and performance management, fostering a culture of continuous improvement and professional growth.
Ability to operate as a subject matter expert related to medical and behavioral health utilization management operations while driving operational optimization.
Aptitude for managing change, navigating complex organizational dynamics with resilience and adaptability.
Proficiency in strategic planning and cultivating strategic partnerships to drive business success.
Expertise in managing diverse customer needs, with a strong focus on delivering exceptional service and satisfaction.
Adept at fostering collaborative decision-making and communication among diverse leadership, committees, and workgroups.
Why us
We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.
Benefits
Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.
The compensation for this role is $75,000 to $83,000 base salary. Based on our compensation program, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.
We do this through our people
You will have meaningful work that genuinely improves people's lives nationwide. Our company cares about our employees, giving you the tools and encouragement, you need to achieve the finest work of your career.
We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!
The Acentra Health Talent Acquisition Team
EOE AA M/F/Vet/Disability
Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local laws.