Clinical, Supervisor - RN - Full-time (Remote U.S.)

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Acentra Health is looking for a Clinical, Supervisor - RN - Full-time (Remote U.S.) to join our growing team.

Job Summary

• As the Clinical Supervisor - RN - Full-time (Remote U.S.), this individual plays a pivotal role in overseeing and managing the Utilization Management (UM) activities within the organization. With a strong clinical foundation and leadership acumen, the Clinical Supervisor ensures that UM processes are executed efficiently, consistently, and in alignment with regulatory and contractual standards. A key focus of the role is to uphold excellence in clinical programs, fostering continuous improvement and innovation in care management practices. Additionally, the Clinical Supervisor is instrumental in cultivating and maintaining strong relationships with customers and stakeholders, ensuring that service delivery meets or exceeds expectations and contractual obligations. The Clinical Supervisor will also have oversight of direct reports. The Clinical Supervisor and direct reports are expected to work Monday through Friday, with participation in a rotating schedule that includes weekends and holidays.

Responsibilities

• Lead and oversee all Utilization Management (UM) activities including prior authorization and retrospective reviews, ensuring accuracy, consistency, and timely completion.
• Conduct utilization reviews as needed to support workload demands and program requirements.
• Monitor daily work queues and adjust staffing schedules to align with departmental demands.
• Evaluate productivity and performance metrics of nurse reviewers to maintain high standards of efficiency and quality.
• Identify onboarding and ongoing learning needs for Clinical Reviewers; collaborate with leadership to design and implement effective development plans.
• Actively participate in leadership meetings, committees, and cross-functional workgroups to promote shared decision-making and continuous improvement.
• Oversee quality assurance activities such as audits, Quality Improvement Plans (QIPs), database management, and Inter-Rater Reliability (IRR) support.
• Identify areas for process and clinical improvements; develop and execute action plans to enhance outcomes.
• Serve as a liaison to customers and providers, ensuring timely resolution of issues and promoting service excellence.
• Stay current with clinical best practices and UM protocols, act as the primary resource for nurse reviewers regarding clinical review inquiries.
• Support departmental and organizational goals by performing additional duties as assigned.
• Read, understand, and adhere to all corporate policies, including policies related to HIPAA and its Privacy and Security Rules.

The above list of responsibilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary.

Required Qualifications/Experience:

• Active, unrestricted Registered Nurse (RN) license in the state of Indiana or a valid compact state license.
• Associate degree or equivalent experience directly applicable to clinical practice.
• 5+ years of experience as a practicing RN.
• 5+ years of supervisory experience in a healthcare setting with a minimum of 2+ years in Utilization Management.
• 2+ years of experience applying InterQual and/or MCG clinical criteria in utilization review processes.

Preferred Qualifications/Experience:

• Bachelor's degree preferred.
• Strong verbal and written communication skills, with the ability to convey complex information clearly and professionally.
• Demonstrated customer-centric approach with a focus on achieving results and fostering positive relationships with internal and external stakeholders.
• Excellent organizational and time management skills, with the ability to prioritize multiple tasks effectively.
• Proven ability to work both independently and collaboratively within a team environment.
• Proficiency in Microsoft Office Suite and other relevant software applications essential to the role.
• Ability to provide technical guidance and leadership support to management and clinical teams.

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Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

Compensation

The pay range for this position is listed below.

"Based on our compensation philosophy, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level."

Thank You!

We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

Visit us at Acentra Health

EEO AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.