Director of Clinical Operations

15 hours ago

🥔 Idaho – Remote

Although this job is listed in Idaho, this company may be open to hiring remote in other states.

🎰 Nevada – Remote

Although this job is listed in Nevada, this company may be open to hiring remote in other states.

+2 more states

🥔 Idaho – Remote 🎰 Nevada – Remote 🌲 Oregon – Remote ☕ Washington – Remote

💵 $115k - $150k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

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Innovative Care Management, Inc.

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We are proud to have been trusted by patients and clients across all 50 states over the last 30 years. As an independent organization, our priority will always be generating the best outcome for you, your family, and your team. We look forward to showing you the ICM difference.

51 - 200 employees

📋 Description

• Guide Clinical Teams & Leaders • Provide daily leadership to UM and CM teams, supporting clinical managers in fostering consistency, engagement, and accountability. • Champion ICM’s culture and values, ensuring teams feel supported, equipped, and inspired. • Strengthen Operational Excellence • Design and refine workflows for efficiency, timeliness, and regulatory compliance. • Partner cross-functionally with Precertification, Member Engagement, Client Services, and others to ensure a seamless experience across the clinical continuum. • Establish and track KPIs, leading teams toward measurable improvement. • Advance Quality & Regulatory Compliance • Maintain rigorous oversight of policies, procedures, and documentation. • Collaborate with the Quality Department on audits, performance trends, and targeted interventions. • Ensure alignment with accreditation standards and evolving regulatory requirements. • Drive Innovation & Strategic Growth • Transform clinical strategy into operational practice in partnership with executive leadership. • Evaluate new tools, processes, and clinical models that improve quality, efficiency, and member outcomes. • Support program evolution to meet emerging market and client needs. • Serve as a Clinical Partner to Clients • Represent clinical operations in client meetings, audits, and implementations. • Ensure clinical deliverables meet contractual expectations and elevate the client experience.

🎯 Requirements

• Active, unrestricted RN license • Associate’s or Bachelor’s degree in Nursing • At least 8 years of clinical experience, with 3–5 years of leadership experience in Utilization Management, Case Management, or Managed Care (preferably on the payer side) • Demonstrated success leading clinical teams through growth or operational transformation • Strong analytical skills and comfort with clinical and operational data • Excellent communication, emotional intelligence, and relationship management • Experience navigating complex or sensitive clinical and operational scenarios with sound judgment • Preferred: Experience in a TPA or self-funded health plan environment • Preferred: Leadership experience with remote or geographically dispersed teams • Preferred: Familiarity with EMRs, utilization review software, and medical necessity criteria • Preferred: Certifications such as CCM, CPHM, or CPUR

🏖️ Benefits

• Multiple medical plan options (including an HSA plan with employer contributions) • Dental and vision coverage • Company-paid basic life and AD&D • Voluntary supplemental coverages • Tax-advantaged savings accounts • 401(k) with employer match • Employee Assistance Program with 24/7 support