Clinical Director - Remote (CA Preferred, Must Work PST Hours)

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

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

Job Summary

Acentra Health is seeking a passionate, experienced, and results-driven Clinical Director to join our growing organization. In this pivotal leadership role, you will play a vital part in advancing Acentra Health's long-term growth, with direct visibility to executive leadership and meaningful influence over strategic initiatives and organizational direction.

As the Clinical Director, you will lead and oversee all clinical program operations. You will guide the program toward enhanced clinical efficiency, operational effectiveness, and superior quality outcomes ensuring that all deliverables and contractual obligations consistently meet the highest standards. This role offers the opportunity to build and inspire high-performing clinical teams, drive continuous improvement, and lead impactful, quality-focused initiatives within a mission-driven organization dedicated to improving lives and delivering exceptional healthcare solutions.

Responsibilities

• Lead a team that will be responsible for conducting utilization management (UM) reviews across a broad spectrum of clinical specialties, including Advanced Imaging, Audiology, Chiropractic, Dental, Durable Medical Equipment (DME), Home Health, Hospice, Inpatient, Mental Health (including Psychiatry), MRO, Occupational Therapy, Optometry, Outpatient, Pharmacy, Physical Therapy, Physician Services, Podiatry, Rehabilitation, Speech Therapy, Transplant, and Transportation, ensuring timely, evidence-based, and compliant determinations.

• Direct and manage care coordination services for a defined member population, ensuring continuity of care, optimal outcomes, and high-quality service delivery.

• Provide leadership, coaching, and performance oversight to direct reports, ensuring excellence in utilization management reviews and case management practices.

• Ensure clinical operations consistently meet contractual, regulatory, and performance requirements by monitoring key performance indicators, analyzing trends, and implementing corrective actions as needed.

• Identify and implement opportunities to improve operational efficiency, productivity, quality outcomes, and service delivery through process improvement initiatives and best practices.

• Serve as a Subject Matter Expert (SME), providing clinical guidance, operational insight, and decision support to internal stakeholders and leadership teams.

• Contribute to the achievement of annual organizational goals, strategic initiatives, and operational performance indicators.

• Foster open, effective communication and engagement across teams through regular one-on-one meetings, team forums, and cross-functional collaboration.

• Oversee contract execution and performance, including service level agreement (SLA) metrics, workflow optimization, staff development, internal training programs, quality of clinical reviews, case management effectiveness, deliverable tracking, and budget compliance.

• Lead the clinical quality program, including auditing activities, Quality Improvement Plans (QIPs), regulatory readiness, and administration of the Local Quality Improvement Committee.

• Perform additional duties as assigned to support clinical operational excellence, strategic initiatives, and organizational objectives.

• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privcy and Security Rules.

• Must hold an active, unrestricted California Registered Nurse (RN) license (compact eligible) or an active, unrestricted Licensed Clinical Social Worker (LCSW) license at time of hire, or obtain California licensure within 90 days of start date.

• Bachelor's degree in Nursing, Healthcare Administration, or a related field, or an equivalent combination of education and directly applicable professional experience.

• Demonstrated expertise in leading and managing clinical care management and utilization management (UM) operations in a healthcare environment.

• Minimum of 3 years of hands-on utilization review experience in a managed care or clinical setting.

• Minimum of 4 years of clinical management or supervisory experience, with proven ability to lead teams and drive performance outcomes.

• Working knowledge of utilization management, case management, and managed care principles and practices.
• Ability to collaborate effectively within multidisciplinary teams and contribute to shared decision-making across leadership groups, committees, and workgroups.
• Experience utilizing clinical and operational systems that support utilization management and case management workflows.
• Strong leadership in employee development, coaching, performance management, and strategic guidance to teams and cross-functional partners.

• Proven ability to evaluate to operational workflows, develop policies, and implement process improvements that drive efficiency, quality, and regulatory compliance.
• Demonstrated ability to develop, plan, and execute short- and long-term operational goals and strategic initiatives.
• Customer-focused and results-driven, with a proven ability to build and sustain strong relationships with internal and external stakeholders.
• Exceptional verbal and written communication skills, with the ability to clearly articulate complex clinical and operational concepts, complemented by strong interpersonal skills and the ability to engage effectively across diverse populations and organizational levels.
• Current working knowledge of InterQual and Milliman clinical criteria.
• Skilled in managing diverse customer needs while maintaining service excellence and consistent operational performance.
• Highly organized with strong time management skills with the ability to effectively prioritize multiple projects and competing deadlines.
• Proficiency in Microsoft Office applications and other business software tools required to perform job functions efficiently.

Why us

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

We do this through our people

You will have meaningful work that genuinely improves people's lives 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!

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 law.

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.

Compensation

The compensation for this role is $117,000.00 - $145,000.00 annual 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.

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