Director of Clinical Operations
Innovative Care Management, Inc.
full-time
Posted on:
Location Type: Hybrid
Location: Idaho, Nevada, Oregon, Washington • 🇺🇸 United States
Visit company websiteSalary
💰 $115,000 - $150,000 per year
Job Level
Lead
About the role
- 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.
- Leadership experience with remote or geographically dispersed teams.
- Familiarity with EMRs, utilization review software, and medical necessity criteria.
- Certifications such as CCM, CPHM, or CPUR.
Benefits
- A Mission That Matters You’ll be part of an organization committed to human-centered healthcare management, where compassion and clinical expertise work hand in hand.
- A Values-Driven Culture Our core values shape how we show up for one another and for the people we serve.
- A Remote-First Workplace Work where you do your best work, with opportunities to connect and collaborate across teams.
- Meaningful Work and Real Impact Every role at ICM contributes to improving health outcomes and strengthening the experience for members and clients nationwide.
- Competitive, Comprehensive Benefits We offer 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, a 401(k) with employer match, and an Employee Assistance Program with 24/7 support.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
clinical experienceleadership experienceUtilization ManagementCase ManagementManaged Careanalytical skillsclinical dataoperational dataEMRsutilization review software
Soft skills
communicationemotional intelligencerelationship managementsound judgmentleadershipteam managementoperational transformationgrowth leadershipcollaborationinnovation
Certifications
RN licenseCCMCPHMCPUR