Role Description
Acentra Health is looking for a Clinical Manager (RN) to join our growing team!
The Clinical Manager (RN) will provide overall clinical and operational leadership for the CA UIS (Unsatisfactory Immigration Status) Care Coordination and Case Management programs. This position is responsible for overseeing program performance, ensuring high standards of clinical quality and member engagement, and driving operational excellence to successfully meet and exceed contract requirements.
The Clinical Manager will provide leadership and direction to clinical staff, oversee care coordination and case management activities, monitor program outcomes and deliverables, and serve as a key clinical resource for internal leadership and stakeholders.
This is a remote position within California, with a preference for candidates located in the Sacramento, Los Angeles, or San Diego areas.
Responsibilities:
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Provide overall clinical and operational leadership for Care Coordination and Discharge Case Management activities.
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Manage, direct, and evaluate program activities to ensure clinical quality, operational effectiveness, and consistency across care coordination and case management functions.
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Provide leadership and oversight of Case Managers and Care Coordinators, including performance management, coaching, development, and accountability for program outcomes.
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Ensure program deliverables, clinical efficiencies, workflows, and contract requirements are consistently achieved and maintained at a high standard.
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Monitor key performance indicators, productivity, quality metrics, and program outcomes; identify opportunities for improvement and implement corrective actions as needed.
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Oversee the consistency and effectiveness of member outreach, engagement, care coordination, and transition-of-care activities.
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Serve as a Clinical Subject Matter Expert (SME) and provide guidance on complex clinical and operational issues.
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Partner with senior leadership and cross-functional teams to identify opportunities for process improvement, resolve operational challenges, and support strategic program initiatives.
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Lead and participate in leadership committees, work groups, and cross-functional initiatives, fostering collaborative decision-making among diverse stakeholders.
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Ensure adherence to applicable clinical standards, regulatory requirements, contract obligations, and Acentra Health policies and procedures.
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Review program performance and provide leadership with updates, recommendations, and actionable insights related to clinical operations, quality, and contract performance.
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Support the development and implementation of policies, procedures, workflows, and initiatives that enhance clinical effectiveness and member outcomes.
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Promote a culture of accountability, collaboration, continuous improvement, and high-quality member service.
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Perform other duties as assigned.
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Read, understand, and adhere to all corporate policies, including policies related to HIPAA and its Privacy and Security Rules.
Qualifications
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Active, unrestricted Licensed Registered Nurse (RN) or compact license.
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Associate degree, OR 7 years equivalent experience in nursing, healthcare administration or related field.
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A minimum of 5+ years being in health care management, supervisory, lead, or team leadership experience in a healthcare, human services, care coordination, or related environment.
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Demonstrated effective verbal and written communication skills essential.
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Customer-focused, results-oriented, and capable of building and maintaining relationships with internal and external customers.
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Organizational skills, ability to plan and prioritize multiple assignments essential.
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Computer proficiency in Microsoft Office applications and other software programs essential to perform job functions.
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Ability to provide clinical guidance and leadership to care coordination team.
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Flexibility to travel up to 25% within CA as needed.
Requirements
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Bachelor's degree (preferred).
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Bilingual candidates are preferred, including Spanish, Chinese, Russian, Farsi, and other languages.
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Current working knowledge of care coordination and case management.
Benefits
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Comprehensive health plans.
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Paid time off.
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Retirement savings.
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Corporate wellness.
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Educational assistance.
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Corporate discounts.
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And more.