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Clinical Quality and Training Manager

Location: Portland, OR
Job Code: 314
# of Openings: 1


Clinical Quality and Training Manager – Utilization Review



AllMed Healthcare Management is seeking a Clinical Quality and Training Manager with Utilization Review and Lean experience to join our clinical operations leadership team as we continue to build our profile as a national leader in the industry.  


What is unique about clinical leadership opportunities at AllMed Healthcare Management?  Opportunity to learn from other leaders with varying backgrounds in a matrixed leadership model, superb culture, dedicated and capable team members, innovation in technology and learning, organizational agility, opportunity for professional career growth, and interaction with national healthcare payer clients.

In this position, you will have overall responsibility to plan, develop, implement and maintain the Clinical Operations Quality and Training Program; collaborate with the Clinical Operations Production Manager and team leads to manage daily clinical case review production; act as a mentor and leader to clinical team in the professional practice of nursing as it applies to utilization management and independent review; ensure operational excellence, process improvement, and customer satisfaction through application of Lean management principles. The Clinical Quality and Training Manager provides leadership to clinical staff to ensure achievement of key performance metric targets and delivery of high-quality, on-time reviews to our clients.

AllMed Healthcare Management’s mission is to improve the quality and integrity of healthcare by providing independent medical review and utilization management 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 are a Lean organization committed to driving continuous performance improvement in all facets of our work.


Your responsibilities will include:


  • Manage and direct clinician team to ensure high-quality, accurate and on-time reviews.
  • Manage Clinical Operations quality and training program to effectively and efficiently onboard new hires and ensure ongoing upskilling of existing staff.
  • Manage development and maintenance of standard work documents, job aids, templates, and clinical content to support high-quality, consistent, and efficient review of cases. 
  • Monitor, analyze, track, report and act on key performance metrics to achieve quality targets.
  • Manage team performance, lead by example, and mentor team members to increase efficiency, quality and capability.
  • Participate in recruitment and hiring activities to identify and onboard high-performing clinicians to increase capacity.
  • Collaborate effectively with the Clinical Operations Production Manager to ensure appropriate workload balance and achievement of case flow targets.
  • Collaborate effectively with medical staff and physicians to provide feedback and support to specialty reviewers to ensure high-quality reviews.
  • Collaborate with Sales to support and respond to client needs and ensure smooth implementation process for new clients.
  • Collaborate with IT to support development and enhancement of automation and tools to increase efficiency and quality of reviews, including support of end user acceptance testing.
  • Participate in cross functional teams and Lean continuous improvement activities including root cause identification and problem solving to improve processes.
  • Other duties as directed by Senior Clinical Operations leadership.


Qualifications include:


  • Bachelor’s degree in Nursing with current unrestricted Registered Nurse license required
  • Experience in utilization review/management, case management, appeals management or related area required
  • At least 3 years of leadership/management experience, preferably within a production-oriented utilization review, case management or clinical operations setting. 
  • Master’s degree in Nursing, Education, Administration or similar preferred.
  • Clinical nursing background required
  • Experience developing and managing training and quality programs
  • Experience and/or formal training in Lean preferred 
  • Strong analytical skills, using Excel and other tools to develop/model production metrics and trends  
  • Demonstrated ability to effectively respond with urgency to issues impacting production and quality
  • 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 prioritizing and managing projects
  • Ability to effectively manage change
  • Strong multi-tasking, decision making and advanced problem solving skills 
  • Outstanding interpersonal, teamwork and verbal communication skills
  • Ability to type at least 35 words per minute



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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.