Remote Clinical Operations Manager – PIP/No-Fault

Ime Resources Llc; Mount Laurel Township (NJ); Remote; USD 110,000 - 160,000; Full time

Job summary

ExamWorks, LLC is seeking a Clinical Operations Manager to lead utilization management and No-Fault (PIP) programs in a fully remote role. You will mentor a remote clinical team, partner with physicians and operations to standardize guidelines and workflows, and drive quality outcomes across regulatory compliance and HIPAA standards.

The role emphasizes process improvement, staff training, and cross-functional collaboration to support client and patient outcomes while optimizing productivity and

Qualifications

• Active unencumbered RN license required.
• Strong knowledge of medical terminology, anatomy & physiology, medications, labs, and evidence-based treatment practices.
• Knowledge of NJ AICRA and Michigan PIP regulations preferred.
• Experience in utilization review, clinical operations, and insurance-related healthcare services preferred.
• Leadership experience overseeing teams and improving processes.

Responsibilities

• Oversee departmental operations to ensure services are delivered effectively and in compliance with regulatory requirements and HIPAA standards.
• Manage daily workflow and adjust to achieve quality, productivity and service goals.
• Provide training, tools, and resources to staff to achieve departmental excellence.
• Review QA and performance data and implement improvement strategies.
• Collaborate with physicians and consulting clinical resources to support quality initiatives and program development.
• Oversee provider appeals and escalated clinical issues as needed.

Skills

Leadership

Analytical thinking

Communication

Clinical judgment

Regulatory knowledge

Education

Bachelor's degree in nursing/healthcare administration

Tools

Microsoft Word

Excel

Outlook

Job description

ExamWorks, LLC is seeking a Clinical Operations Manager to lead utilization management and No-Fault (PIP) programs in a fully remote role. You will mentor a remote clinical team, partner with physicians and operations to standardize guidelines and workflows, and drive quality outcomes across regulatory compliance and HIPAA standards.

The role emphasizes process improvement, staff training, and cross-functional collaboration to support client and patient outcomes while optimizing productivity and