[Hiring] Clinical Supervisor @Acentra Health, LLC

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.

Responsibilities:

• Lead and oversee all Utilization Management (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; develop and execute action plans.
• Serve as a liaison to customers and providers, ensuring timely resolution of issues.
• 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.
• A minimum of 2+ years of experience applying InterQual and/or MCG clinical criteria.
• Strong verbal and written communication skills.
• Demonstrated customer-centric approach.
• Excellent organizational and time management skills.
• Proven ability to work both 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.