Remote Healthcare administration Jobs • Clinical

The Utilization Management Clinical Specialist will play an important role in SmarterDx’s next product launch in the Utilization Management and Case Management space. This role will work closely with Product and Data Science to design and refine strategies that help hospitals optimize resource use, ensure appropriate levels of care, and support timely and effective patient management. The specialist will bring a clinical and operational view to patient status determination, documentation workflows, and utilization review, contributing to AI tools that support care coordination and medical necessity compliance.

This role provides cross- market clinical leadership and oversight, ensuring excellence in care delivery across Nest Health's growing footprint by supporting and supervising Advanced Practice Provider (APP) Pod Leaders and contracted physicians. A key leader in Nest's clinical leadership team reporting to the Chief Clinical Officer. The role drives performance in quality, patient experience, clinical outcomes, and value-based care.