[Hiring] Clinical Operations Manager @IME RESOURCES LLC

Role Description

ExamWorks is seeking a Clinical Operations Manager to play a key role in shaping and enhancing our clinical programs while leading a high-performing remote team.

In this 100% fully remote position, you'll provide clinical leadership across utilization management and No-Fault (PIP) programs, helping ensure services are delivered efficiently, compliantly, and with the highest level of quality. You'll partner with operational leaders, physicians, and clinical experts to develop best practices, improve workflows, strengthen provider relationships, and support strategic initiatives that directly impact client and patient outcomes.

The schedule for the role is either 8:00am-5:00pm EST or 8:00am-5:00pm CST.

This is an excellent opportunity for someone who enjoys looking beyond day-to-day operations to identify opportunities for improvement, develop clinical guidelines, and help build scalable processes that support organizational growth.

Qualifications

• Bachelor's degree in nursing, business management, healthcare administration, or related field preferred.
• Minimum of six years related clinical experience, including at least three years of leadership or management experience; or equivalent combination of education and experience.
• Experience in utilization review, clinical operations, and insurance-related healthcare services preferred.
• Knowledge of the insurance industry and no-fault (PIP), workers' compensation, liability, and disability claims environments preferred.

Requirements

• Active unencumbered Registered Nursing license required.
• Strong knowledge of medical terminology, anatomy and physiology, medications, laboratory values, and evidence-based treatment practices.
• General knowledge of automobile claims regulations as they relate to No-Fault (PIP) programs and utilization review practices.
• Detailed knowledge of New Jersey AICRA and Michigan PIP regulations is preferred.
• Working knowledge of nationally recognized treatment guidelines and evidence-based clinical review resources utilized in utilization review operations.
• Working knowledge of medical records, health information principles, and medical-legal documentation.
• Strong analytical skills and the ability to evaluate operational, quality, and productivity data to support departmental goals and performance outcomes.
• Strong critical thinking, clinical judgment, and decision-making abilities.
• Ability to follow instructions and respond appropriately to management direction.
• Proficient in Microsoft Word, Outlook, Excel, Internet applications, and other business-related software programs.
• Ability to operate standard office equipment, including computer, copier, scanner, and telephone.
• Excellent verbal, written, and interpersonal communication skills.
• Ability to effectively communicate and collaborate with physicians, healthcare providers, clients, and internal stakeholders.
• Demonstrate accuracy, thoroughness, accountability, and a commitment to quality while identifying opportunities for continuous improvement.
• Exercise sound judgment, make informed decisions, and appropriately involve others in the decision-making process.
• Ability to work independently, prioritize responsibilities, and manage multiple competing priorities.
• Strong analytical and problem-solving skills, including the ability to evaluate clinical, operational, and quality-related information and implement effective solutions.
• Maintain confidentiality and handle sensitive information appropriately.
• Foster and promote a positive, team-oriented work environment.
• Remain focused and productive in a fast-paced environment with frequent interruptions.
• Perform effectively under pressure and meet established deadlines.
• Adapt to changing priorities, manage change effectively, and respond appropriately to unexpected situations.
• Follow all company policies and procedures in effect at time of hire and as amended.

Benefits

• Fast-paced team atmosphere.
• Competitive benefits (medical, vision, dental).
• Paid time off.
• 401k.

Company Description

ExamWorks is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers' compensation insurance coverages.

ExamWorks, LLC 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, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws.

Equal Opportunity Employer - Minorities/Females/Disabled/Veterans