Clinical Director-AR UM

CNSI and Kepro are now Acentra Health! 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 is looking for a Clinical Director to join our growing team.

Job Summary :

The Clinical Director is responsible for the management and oversight of Arkansas Utilization Management Contract activities within clinical, contractual, and budgetary parameters.

This position directs and oversees all clinical program activities to ensure overall consistency, and accuracy of the clinical programs and ensures clinical efficiencies, deliverables and provide day-to-day oversight to manage multiple areas of the UM program and oversee the implementation of clinical contract requirements and Medicaid rules and regulations.

Job Responsibilities :

• Responsible for UM reviews such as : Inpatient (Under 21) and Outpatient Behavioral Health, Pediatric Developmental Disability Services, Personal Care Services, Applied Behavioral Analysis and Dental program.
• Advises and manages direct reports relative to their responsibilities for utilization management review; including but not limited to operational standards and quality outcomes, regulatory and contractual compliance, policy and procedures and quality monitoring, and adherence to Medicaid rules and regulations.
• Ensure compliance with contractual requirements within the clinical operation by monitoring critical indicators and adjusting processes to compensate for negative variances.
• Identify areas to improve operating efficiencies.
• Serve as a Subject Matter Expert (SME).
• Assists in achieving annual organizational priorities and operational indicators.
• Foster and maintain strong communications with staff through various means; e.g., one-on-one meetings, team meetings, and interdepartmental meetings.
• Responsible for clinical quality program to include auditing, Quality Improvement Plans (QIP’s) and administration of the Local Quality Improvement Committee.
• Identify problems caused by software glitches and flaws and work with IT and staff to resolve the problem.

Requirements

Required Qualifications / Experience

• Active, unrestricted Licensed in one of the following : RN in Arkansas or compact state, Social Work, Licensed Professional Counselors, PT, OT and ST
• Bachelor’s Degree or equivalent directly applicable experience in nursing, healthcare administration or related area, Master's level is preferred.
• Knowledge of Arkansas and Federal Medicaid rules and regulations.
• Current working knowledge of utilization management, case management, and managed care.

Additional Qualifications / Experience :

• Skill in examining and re-examining operations and procedures, formulating policy, and developing and implementing new strategies and procedures.
• Knowledge of U.S. healthcare industry
• Experience in using systems that support Utilization and Case Management processing
• Understanding of URAC standards and processes

Benefits

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 $101,430- $140,900

Based on our compensation program, 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.com / careers /

EOE 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, gender identity, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.