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Clinical Operations Director

Location: Portland, OR
Job Code: 313
# of Openings: 1


Clinical Operations Director


AllMed Healthcare Management’s mission is to improve the quality and integrity of healthcare by providing independent medical review services that help payers and providers deliver better health outcomes. We partner with hundreds of leading health insurance and hospital organizations and have maintained consistent growth, through our commitment to the highest quality, client satisfaction, and technology innovation.  Services are delivered through PeerPoint®, AllMed’s state-of-the-art medical review portal.  We have recently undergone a Lean transformation in our Clinical Operations, with the goal of driving continuous improvement in our performance.


We are seeking a Clinical Operations Director with Lean experience to join our clinical operations leadership team as we continue to build our profile as a national leader in the industry.  AllMed’s innovative solution for health plans and payer organizations allows them to partner with AllMed for utilization management solutions, with a primary focus on specialist reviews of pre-authorization and appeals.  Our business has grown steadily over the past several years, as health plans seek to outsource more of their routine physician review processes to companies like AllMed.


In this position, you will have overall responsibility for the Clinical Operations team, ensuring that AllMed meets its clients’ requirements for capacity, quality and turnaround time.  Reporting to the Vice President of Clinical Operations, you will provide leadership to a team of managers and leads in the areas of customer service, case intake, dispatch, physician peer reviewer management, clinical case review, copy editing and quality assurance.


Your responsibilities will include:

  • Developing a vision and strategy for growing and empowering the Clinical Operations team
  • Adapting AllMed’s lean tools to drive continuous improvement in quality, capacity and operational excellence including setting metrics and targets, visual management, standard work, job aids, Gemba, PDCA, etc.
  • Collaborating with the Clinical Quality and Training Manager, Clinical Operations Production Manager, and team leads to manage a team of RNs, LPNs, Allied Health professionals, editors, and administrative staff to optimize production efficiency and quality across the entire value stream, while increasing cross-functional collaboration to reduce waste.
  • Evaluating performance, providing feedback and empowering team members to grow professionally and as subject matter experts in Utilization Management
  • Recruiting, training, onboarding and employee performance management to increase capacity and flexibility
  • Partnering with our Sales & Account Management teams on new account evaluation, intake, program design, deployment and ongoing client satisfaction
  • Collaborating with our VP/Medical Director, In-House Medical Directors, Clinical Operations management and IT staff to identify and execute improvement initiatives that drive company performance


Qualifications include:

  • Must possess a Bachelor’s degree in nursing and at least 10 years of leadership/management experience within a utilization review, case management or clinical operations setting, preferably within a healthcare payer organization
  • An MBA or advanced degree is strongly preferred
  • Expertise in Medicare and Medicaid utilization management and compliance
  • Experience and/or formal training in Lean strongly preferred
  • Strong analytical skills, using Excel and other tools to develop/model production metrics and trends
  • Strong computer skills, including MS Office and general web applications
  • Experience developing operational standards, including standard work, job aids
  • A passion for empowering and developing employees
  • Effective in client-facing situations with a strong commitment to customer service and satisfaction
  • Strong multi-tasking, decision making and advanced problem solving skills
  • Outstanding interpersonal, teamwork and verbal communication skills


AllMed offers competitive compensation based on experience, comprehensive benefits and a generous vacation package.  AllMed is an equal opportunity employer.

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(800) 400-9916
111 SW Fifth Ave., Suite 1400, Portland, OR 97204
AllMed Healthcare Management, Inc. All rights reserved.

AllMed is an independent review organization with a panel of 400 physician peer reviewers who are licensed, board-certified and in active practice, covering more than 80 ABMS specialties and sub-specialties. AllMed offers medical, copy-editing and customer resources that enable clients to improve quality of care and patient safety.