Following a 2022 merger of CNSI and Kepro, Acentra Health combines clinical services, technology solutions, and data analytics to accelerate better health outcomes. This is a great time to join our team of passionate individuals working together to pursue the most effective solutions to today’s complex healthcare challenges. Our culture is fueled by passion and driven by purpose.

Clinical Supervisor – RN (Remote within Indiana)

• Are you an experienced Clinical Supervisor – RN looking for a new challenge?
• Are you looking to join a team that ensures a collaborative and inviting culture where everyone can thrive?

If so, you might be our next new team member!

** The selected candidate must reside and work in the state of Indiana. **

Who we need:

The Clinical Supervisor – RN is responsible for the management and oversight of the:

• Indiana Utilization Management activities.
• Clinical program activities to ensure overall consistency, thoroughness, and accuracy of the clinical programs.
• Program to ensure clinical efficiencies, deliverables, and assigned contract functions are performed to the highest standards to strengthen the relationships with customers and meet contract requirements.
• Day-to-day oversight to manage the Utilization Review (UR) program and clinical staff to ensure that contractual deliverables are met.

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.

Singularly Focused. Mission Driven.

Accelerating Better Outcomes is our Mantra! We are mission-driven to innovate health solutions that deliver maximum value and impact.

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 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.

What you’ll do:

• Utilization reviews as defined by the contract include prior authorization and retro reviews.
• Oversee utilization review activities.
• Serve as a Subject Matter Expert (SME).

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.

What you’ll need:

Required Qualifications / Experience

• Active, unrestricted Licensed RN in Indiana OR a Compact State License.
• Associate’s Degree or equivalent, directly applicable, experience in nursing, healthcare administration, or a related area.
• 5+ years of experience in a Lead position in a Quality and Utilization Management program, including the 2 most recent years being in healthcare management.

Preferred Qualifications / Experience

• Bachelor’s degree.

Required Knowledge, Skills, Abilities

• Excellent verbal and written communication skills.
• Current working knowledge of utilization management.
• Customer-focused, results-oriented, and capable of building and maintaining relationships with internal and external customers.
• Organizational skills, and the ability to plan and prioritize multiple assignments.
• Knowledge of current InterQual and Milliman Care Guidelines criteria.
• Experience in using systems that support Utilization Review processing.
• Ability to participate as a team member fostering collaborative decision-making among leadership, committees, teams, or work groups of diverse composition.
• Computer proficiency in Microsoft Office applications and other software programs essential to perform job functions.
• Ability to provide technical guidance and leadership to the management team.

Preferred Knowledge, Skills, Abilities

• Experience with following Utilization Review Accreditation Commission (URAC) guidelines.

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

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.