Innovative Care Management, Inc.
Director of Clinical Operations
Innovative Care Management, Inc., Portland, Oregon, United States, 97204
Director of Clinical Operations
Innovative Care Management, Inc.
Innovative Care Management, Inc. (ICM) is devoted to placing people at the heart of every decision. We serve clients nationwide with a values‑driven approach that blends compassion, clinical expertise and operational excellence. Our core values – Kindness, Personal Responsibility, a Can‑Do Attitude, and Humble Confidence – guide how we work, lead and care for those we serve.
The Role We are seeking an experienced, strategic healthcare leader to serve as our Director of Clinical Operations. This pivotal role shapes the performance, culture and future direction of our Utilization Management (UM) and Care Management (CM) programs. The Director will partner closely with the VP of Service Delivery & Strategy and Chief Medical Officer to bring clinical strategy to life, ensuring evidence‑based standards become seamless, compassionate operations. This remote position is open to candidates residing in Oregon, Washington, Idaho or Nevada. Periodic travel to Portland, Oregon is required.
What You’ll Do Guide Clinical Teams & Leaders
Provide daily leadership to UM and CM teams, supporting clinical managers in fostering consistency, engagement and accountability.
Champion ICM’s culture and values, ensuring teams feel supported, equipped and inspired.
Strengthen Operational Excellence
Design and refine workflows for efficiency, timeliness and regulatory compliance.
Partner cross‑functionally with Precertification, Member Engagement, Client Services and others to ensure a seamless experience across the clinical continuum.
Establish and track KPIs, leading teams toward measurable improvement.
Advance Quality & Regulatory Compliance
Maintain rigorous oversight of policies, procedures and documentation.
Collaborate with the Quality Department on audits, performance trends and targeted interventions.
Ensure alignment with accreditation standards and evolving regulatory requirements.
Drive Innovation & Strategic Growth
Transform clinical strategy into operational practice in partnership with executive leadership.
Evaluate new tools, processes, and clinical models that improve quality, efficiency and member outcomes.
Support program evolution to meet emerging market and client needs.
Serve as a Clinical Partner to Clients
Represent clinical operations in client meetings, audits and implementations.
Ensure clinical deliverables meet contractual expectations and elevate the client experience.
Requirements What You Bring
You’ll thrive in this role if you are a thoughtful, decisive, and forward‑thinking clinical leader who believes in balancing compassion with operational excellence.
Required Qualifications
Active, unrestricted RN license.
Associate’s or Bachelor’s degree in Nursing.
At least 8 years of clinical experience, with 3‑5 years of leadership experience in Utilization Management, Case Management or Managed Care (preferably on the payer side).
Demonstrated success leading clinical teams through growth or operational transformation.
Strong analytical skills and comfort with clinical and operational data.
Excellent communication, emotional intelligence and relationship management.
Experience navigating complex or sensitive clinical and operational scenarios with sound judgment.
Preferred
Experience in a TPA or self‑funded health plan environment.
Leadership experience with remote or geographically dispersed teams.
Familiarity with EMRs, utilization review software and medical necessity criteria.
Certifications such as CCM, CPHM or CPUR.
Why Join ICM People choose ICM because they want to make a meaningful impact. We blend clinical expertise with genuine care to create supportive experiences for both members and health plans. At ICM, you’ll find a mission that matters, a values‑driven culture, a remote‑first workplace and meaningful work that contributes to improving health outcomes for members and clients nationwide.
Competitive, Comprehensive Benefits We offer multiple medical plan options (including an HSA plan with employer contributions), dental and vision coverage, company‑paid basic life and AD&D, voluntary supplemental coverages, tax‑advantaged savings accounts, a 401(k) with employer match and an Employee Assistance Program with 24/7 support.
Seniority Level Director
Employment Type Full‑time
Job Function Research, Analyst and Information Technology
Industries Insurance
Referrals increase your chances of interviewing at Innovative Care Management, Inc. by 2x.
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Innovative Care Management, Inc. (ICM) is devoted to placing people at the heart of every decision. We serve clients nationwide with a values‑driven approach that blends compassion, clinical expertise and operational excellence. Our core values – Kindness, Personal Responsibility, a Can‑Do Attitude, and Humble Confidence – guide how we work, lead and care for those we serve.
The Role We are seeking an experienced, strategic healthcare leader to serve as our Director of Clinical Operations. This pivotal role shapes the performance, culture and future direction of our Utilization Management (UM) and Care Management (CM) programs. The Director will partner closely with the VP of Service Delivery & Strategy and Chief Medical Officer to bring clinical strategy to life, ensuring evidence‑based standards become seamless, compassionate operations. This remote position is open to candidates residing in Oregon, Washington, Idaho or Nevada. Periodic travel to Portland, Oregon is required.
What You’ll Do Guide Clinical Teams & Leaders
Provide daily leadership to UM and CM teams, supporting clinical managers in fostering consistency, engagement and accountability.
Champion ICM’s culture and values, ensuring teams feel supported, equipped and inspired.
Strengthen Operational Excellence
Design and refine workflows for efficiency, timeliness and regulatory compliance.
Partner cross‑functionally with Precertification, Member Engagement, Client Services and others to ensure a seamless experience across the clinical continuum.
Establish and track KPIs, leading teams toward measurable improvement.
Advance Quality & Regulatory Compliance
Maintain rigorous oversight of policies, procedures and documentation.
Collaborate with the Quality Department on audits, performance trends and targeted interventions.
Ensure alignment with accreditation standards and evolving regulatory requirements.
Drive Innovation & Strategic Growth
Transform clinical strategy into operational practice in partnership with executive leadership.
Evaluate new tools, processes, and clinical models that improve quality, efficiency and member outcomes.
Support program evolution to meet emerging market and client needs.
Serve as a Clinical Partner to Clients
Represent clinical operations in client meetings, audits and implementations.
Ensure clinical deliverables meet contractual expectations and elevate the client experience.
Requirements What You Bring
You’ll thrive in this role if you are a thoughtful, decisive, and forward‑thinking clinical leader who believes in balancing compassion with operational excellence.
Required Qualifications
Active, unrestricted RN license.
Associate’s or Bachelor’s degree in Nursing.
At least 8 years of clinical experience, with 3‑5 years of leadership experience in Utilization Management, Case Management or Managed Care (preferably on the payer side).
Demonstrated success leading clinical teams through growth or operational transformation.
Strong analytical skills and comfort with clinical and operational data.
Excellent communication, emotional intelligence and relationship management.
Experience navigating complex or sensitive clinical and operational scenarios with sound judgment.
Preferred
Experience in a TPA or self‑funded health plan environment.
Leadership experience with remote or geographically dispersed teams.
Familiarity with EMRs, utilization review software and medical necessity criteria.
Certifications such as CCM, CPHM or CPUR.
Why Join ICM People choose ICM because they want to make a meaningful impact. We blend clinical expertise with genuine care to create supportive experiences for both members and health plans. At ICM, you’ll find a mission that matters, a values‑driven culture, a remote‑first workplace and meaningful work that contributes to improving health outcomes for members and clients nationwide.
Competitive, Comprehensive Benefits We offer multiple medical plan options (including an HSA plan with employer contributions), dental and vision coverage, company‑paid basic life and AD&D, voluntary supplemental coverages, tax‑advantaged savings accounts, a 401(k) with employer match and an Employee Assistance Program with 24/7 support.
Seniority Level Director
Employment Type Full‑time
Job Function Research, Analyst and Information Technology
Industries Insurance
Referrals increase your chances of interviewing at Innovative Care Management, Inc. by 2x.
#J-18808-Ljbffr