Senior Manager, Pre-Cert Operations & Clinical Excellence

Quantum Health; Dublin (OH); On-site; USD 95,000 - 125,000; Full time

Job summary

A healthcare navigation organization is looking for a Manager, Pre‑Cert Operations to oversee execution of Pre-Certification delivery. This role involves leading frontline nurses, ensuring quality, compliance, and performance management, alongside collaborating with clinical leadership. Candidates should have at least 5 years in clinical leadership and utilization management, along with a nursing degree and an active RN license in Ohio. The position offers full-time employment with a focus on people development and operational effectiveness.

Qualifications

• Bachelor’s or Master’s degree in nursing required.
• Current and Active license as a Registered Nurse in Ohio.
• Minimum of 5 years of clinical leadership experience.
• Minimum of 5 years of utilization management experience.
• Strong administrative/technical skills and comfort working on a PC.

Responsibilities

• Manage execution of Pre-Certification delivery.
• Provide leadership and subject matter expertise for frontline Pre-Cert nurses.
• Ensure compliance with relevant regulatory requirements.
• Deliver performance feedback.
• Facilitate team discussions and ensure collaboration.

Skills

Clinical leadership

Utilization management

Strategic planning

Team development and coaching

Data analysis

Administrative skills

Education

Bachelor’s or Master’s degree in nursing

Tools

Microsoft Office (Outlook, Word, Excel, PowerPoint)

Job description

A healthcare navigation organization is looking for a Manager, Pre‑Cert Operations to oversee execution of Pre-Certification delivery. This role involves leading frontline nurses, ensuring quality, compliance, and performance management, alongside collaborating with clinical leadership. Candidates should have at least 5 years in clinical leadership and utilization management, along with a nursing degree and an active RN license in Ohio. The position offers full-time employment with a focus on people development and operational effectiveness.