Director of Clinical Operations
Benefits
Unlimited PTO
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Essential Duties and Responsibilities:
- Provides leadership and operational oversight for Utilization Management (UM), Case Management (CM), and Disease/Population Health Management (DM) programs.
- Ensures care management operations deliver high‑quality, timely, and cost‑effective services in alignment with clinical standards, regulatory requirements, accreditation expectations, and organizational strategy.
- Partners closely with Clinical Compliance, Medical Directors, and operational leadership to drive performance, staff readiness, and continuous improvement.
Operational Strategy & Performance:
- Lead operational strategy across UM, CM, and population health programs.
- Analyze utilization, quality, and outcome data to identify performance trends and opportunities.
- Drive consistency and standardization across teams, states, and client populations.
Qualifications:
- Active, unrestricted Registered Nurse (RN) license
- Strong operational knowledge of UM, CM, and disease management workflows
- Effective people management and coaching skills
Personify Health
Personify Health created the first and only personalized health platform bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. It serves employers, health plans, and health systems with data-driven solutions that reduce costs while actually improving health outcomes.