Clinical, Supervisor

Acentra Health, LLC•UNAVAILABLE, UNAVAILABLE

About The Position

Acentra Health is seeking a Clinical Supervisor (RN) to oversee and manage Utilization Management activities. The role focuses on maintaining high standards across clinical programs, ensuring consistency, thoroughness, and accuracy, and supporting clinical efficiencies, deliverables, and contract functions. The Clinical Supervisor also builds and strengthens customer relationships to help ensure contract requirements are met. The position provides day-to-day oversight of the utilization review program, including prior authorization and retrospective reviews as defined by the contract. It serves as a subject matter expert and contributes to collaborative decision-making with leadership, committees, teams, and work groups. The role also requires adherence to corporate policies, including HIPAA Privacy and Security Rules, and may include other duties assigned by management. Acentra Health describes its work as applying technology, services, and clinical expertise to improve health outcomes. The company notes that employees may use emerging technologies, including artificial intelligence and advanced analytics, to improve processes, decision-making, efficiency, quality, and impact. The position offers a stated pay range of $83,520 to $104,400 per year. Placement within the range depends on considerations including applicable experience and skill level.

Requirements

Active, unrestricted RN license in Indiana or a compact license.
Associate degree or equivalent directly applicable experience in nursing, healthcare administration, or a related area.
At least 2 years of healthcare management experience.
At least 5 years of experience in a lead position in a quality and utilization management program.

Nice To Haves

Bachelor's degree.
Excellent verbal and written communication skills.
Current working knowledge of utilization management.
Customer-focused, results-oriented approach and ability to build and maintain internal and external customer relationships.
Strong organizational skills and ability to plan and prioritize multiple assignments.
Current knowledge of InterQual and Milliman criteria.
Experience using systems that support utilization review processing.
Ability to work both in a team setting and independently.
Computer proficiency in Microsoft Office applications and other software programs needed to perform job functions.
Ability to provide technical guidance and leadership to the management team.

Responsibilities

Manage and oversee Utilization Management activities.
Ensure consistency, thoroughness, and accuracy of clinical programs.
Oversee clinical efficiencies, deliverables, and contract functions to ensure they meet high standards.
Strengthen customer relationships and meet contract requirements.
Provide day-to-day oversight of the utilization review program.
Conduct utilization reviews as defined by the contract, including prior authorization and retrospective reviews.
Serve as a subject matter expert.
Participate as a team member and foster collaborative decision-making among leadership, committees, teams, and diverse work groups.
Read, understand, and adhere to corporate policies, including HIPAA Privacy and Security Rules.
Perform other duties as assigned.