Senior Clinical Operations Leader (RN) – Managed Care

Morgan Consulting Resources, Inc.; Modesto (CA); Vor Ort; USD 200.000 - 300.000; Vollzeit

Zusammenfassung

AllCare IPA in Modesto, CA, seeks an experienced Clinical Operations Leader (RN) to oversee medical management functions onsite. Reporting to the CEO, you will lead a team of about 24 nurses and clinical staff, ensuring regulatory integrity within a capitated managed care environment.

The role requires CA licensed RNs with 5–7 years in healthcare management, especially in delegated IPA or medical groups, and strong CMS/DHCS knowledge.

Qualifikationen

• Current, unrestricted RN license.
• 5–7 years of clinical and healthcare management experience.
• 5–7 years of clinical management in California delegated capitated IPA/medical group/health plan.
• Strong knowledge of California managed care regulations.
• Experience interacting with CMS, DHCS, NCQA, and health plan delegation.

Aufgaben

• Provide executive-level leadership for medical management operations.
• Direct a team of ~24 nurses and clinical staff, including hiring, coaching, performance management, and staff development.
• Establish departmental goals, workflows, and accountability aligned with objectives.
• Serve as the primary clinical operations liaison with IPA, plans, physicians, hospitals, and regulators.
• Promote patient-centered care, operational excellence, and continuous improvement.

Kenntnisse

Leadership

Healthcare management

California regulatory knowledge

CMS knowledge

Quality improvement

Population health

Ausbildung

RN license

California licensure eligible

Jobbeschreibung

AllCare IPA in Modesto, CA, seeks an experienced Clinical Operations Leader (RN) to oversee medical management functions onsite. Reporting to the CEO, you will lead a team of about 24 nurses and clinical staff, ensuring regulatory integrity within a capitated managed care environment.

The role requires CA licensed RNs with 5–7 years in healthcare management, especially in delegated IPA or medical groups, and strong CMS/DHCS knowledge.