RN Clinical Operations Leader — Managed Care (CA)

Morgan Consulting Resources, Inc. - Healthcare Executive Search

Modesto (CA)

On-site

USD 150,000 - 190,000

Full time

4 days ago

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Job summary

AllCare IPA in Modesto, CA is seeking a Clinical Operations Leader (RN) to guide a team of about 24 nurses and clinical staff. The role focuses on strategic oversight, operational performance, and regulatory integrity within a capitated managed care framework.

The ideal candidate will bring a California RN license, 5–7 years of clinical management experience in delegated IPA/health plan settings, and strong knowledge of CMS/DHCS requirements to drive quality and efficiency.

Qualifications

Current, unrestricted RN license and eligibility to obtain California RN licensure.
5-7 years of clinical and healthcare management experience including in the acute hospital setting.
Minimum of 5-7 years of clinical management experience in California delegated capitated IPA, medical group, health plan, or managed care organization.
Strong knowledge of California managed care regulations in a risk-based environment.
Experience interacting with CMS, DHCS, NCQA, and health plan delegation.

Responsibilities

Oversee a team of approximately 24 nurses and clinical support staff.
Provide strategic oversight, operational performance, and regulatory integrity of medical management within a capitated managed care environment.