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. 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. You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.
Clinical Supervisor
Location
United States
Posted
13 days ago
Salary
$84.1K - $95K / year
Seniority
Mid Level
No structured requirement data.
Job Description
Role Description
Acentra Health is looking for a Clinical Supervisor - RN - Full-time to join our growing team. As the Clinical Supervisor, this individual plays a pivotal role in overseeing and managing the Utilization Management (UM) activities within the organization.
- Ensure UM processes are executed efficiently, consistently, and in alignment with regulatory and contractual standards.
- Uphold excellence in clinical programs, fostering continuous improvement and innovation in care management practices.
- Cultivate and maintain strong relationships with customers and stakeholders, ensuring service delivery meets or exceeds expectations.
- Oversee direct reports and participate in a rotating schedule that includes weekends and holidays.
This position is remote U.S.
Working hours between 8:00 a.m. and 6:00 p.m. EST, with rotational evenings, weekends, and holidays as required.
- Lead and oversee all UM activities including prior authorization and retrospective reviews.
- Conduct utilization reviews as needed to support workload demands and program requirements.
- Monitor daily work queues and adjust staffing schedules to align with departmental demands.
- Evaluate productivity and performance metrics of nurse reviewers.
- Identify onboarding and ongoing learning needs for Clinical Reviewers.
- Participate in leadership meetings, committees, and cross-functional workgroups.
- Oversee quality assurance activities such as audits and Quality Improvement Plans (QIPs).
- Identify areas for process and clinical improvements and develop action plans.
- Serve as a liaison to customers and providers.
- Stay current with clinical best practices and UM protocols.
- Support departmental and organizational goals by performing additional duties as assigned.
- Read, understand, and adhere to all corporate policies, including HIPAA policies.
Qualifications
- Active, unrestricted Registered Nurse (RN) license in the state of Indiana or a valid compact state license.
- Associate degree or equivalent experience directly applicable to clinical practice.
- A minimum of 5+ years of experience as a practicing RN.
- A minimum of 5+ years of supervisory experience in a healthcare setting with at least 2+ years in Utilization Management.
- A minimum of 2+ years of experience applying InterQual and/or MCG clinical criteria in utilization review processes.
- Strong verbal and written communication skills.
- Demonstrated customer-centric approach.
- Excellent organizational and time management skills.
- Proven ability to work independently and collaboratively.
- Proficiency in Microsoft Office Suite and other relevant software applications.
Requirements
- Working hours between 8:00 a.m. and 6:00 p.m. EST, with rotational evenings, weekends, and holidays as required.
Benefits
- Comprehensive health plans.
- Paid time off.
- Retirement savings.
- Corporate wellness.
- Educational assistance.
- Corporate discounts.
- And more.
Job Requirements
- Active, unrestricted Registered Nurse (RN) license in the state of Indiana or a valid compact state license.
- Associate degree or equivalent experience directly applicable to clinical practice.
- A minimum of 5+ years of experience as a practicing RN.
- A minimum of 5+ years of supervisory experience in a healthcare setting with at least 2+ years in Utilization Management.
- A minimum of 2+ years of experience applying InterQual and/or MCG clinical criteria in utilization review processes.
- Strong verbal and written communication skills.
- Demonstrated customer-centric approach.
- Excellent organizational and time management skills.
- Proven ability to work independently and collaboratively.
- Proficiency in Microsoft Office Suite and other relevant software applications.
- Working hours between 8:00 a.m. and 6:00 p.m. EST, with rotational evenings, weekends, and holidays as required.
Benefits
- Comprehensive health plans.
- Paid time off.
- Retirement savings.
- Corporate wellness.
- Educational assistance.
- Corporate discounts.
- And more.
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