Remote RN Clinical Operations Lead

Acentra Health, LLC; United States; Remote; USD 94,000 - 105,000; Full time

Benefits offered by this job

comprehensive health plans

paid time off

retirement savings

corporate wellness

educational assistance

corporate discounts

more

Job summary

Acentra Health is seeking a Clinical Operations Manager - RN to supervise the case review teams and ensure quality and regulatory contract deliverables. The role emphasizes mentoring, coaching, and supporting an interdisciplinary team to meet payer/client requirements.

The position is remote with standard hours 9:00 AM–5:30 PM EST, Monday to Friday, with possible after-hours work. Strong leadership and regulatory knowledge are essential for success.

Qualifications

• Active, unrestricted RN licensure.
• Pursuing ongoing education and self-development to stay current with case review standards.
• 4+ years of clinical experience in a medical setting.
• Quality management experience with projects or reporting outcomes.
• Case review experience with evidence-based practice standards.
• Knowledge of the No Surprises Act and Dispute Resolution.

Responsibilities

• Supervise, mentor, coach, and develop the case review team in the clinical area of case review and dispute resolution.
• Oversee workload, assess, evaluate, and address assignments; adjust to contract requirements.
• Develop staff, identify orientation and learning needs, and implement plans.
• Quality monitoring; ensure compliance with regulatory and contractual standards.
• Develop and revise case review tools to support programs.
• Maintain open communication and timely documentation and reporting.
• Maintain client confidentiality and comply with HIPAA policies.
• Participate in contract management activities and deliverables.
• Perform other duties related to case review supervision.
• Read, understand, and adhere to corporate policies including HIPAA.

Skills

Mentoring

Coaching

Communication skills

Problem solving

Conflict resolution

Team leadership

Education

Bachelor's degree in nursing or related field

Job description

Acentra Health is seeking a Clinical Operations Manager - RN to supervise the case review teams and ensure quality and regulatory contract deliverables. The role emphasizes mentoring, coaching, and supporting an interdisciplinary team to meet payer/client requirements.

The position is remote with standard hours 9:00 AM–5:30 PM EST, Monday to Friday, with possible after-hours work. Strong leadership and regulatory knowledge are essential for success.