• Manage Specialty Therapy and Rehabilitation Services (STRS) clinical services including management and marketing of clinical services • Manage clinical services including oversight of clinical policies and procedures and day-to-day operation • Oversee the provider outreach and training activities pre and post implementation • Ensure compliance with established initial and concurrent review, referral, and authorization policies, procedures and processes • Ensure all programs and clinical operations are in full compliance with state and federal regulations, including HIPAA • Ensure payer contract clinical deliverables are met • Monitor the effectiveness of existing procedures and outreach/intervention efforts and ensure full compliance with physical, occupational, speech, and home health scope of practice state guidelines • Analyze data, monitor trends and recommend potential quality improvement opportunities including provider issues, service gaps, member needs • Ensure accurate and timely reporting to health plan partners on authorizations, denials, appeals, provider outreach, call center metrics, and utilization trends to include analytics and interventions • Performs other duties as assigned • Complies with all policies and standards