Clinical Quality, Manager
Acentra Health - United States
Hiring: Clinical Quality, Manager Company: Acentra Health Location: United States Job Posted Time: 2026-09-03 11:00:30 Employment Type: Contract Target Skills & Keywords : Clinical Documentation, HIPAA, Medicaid, Microsoft Office, Quality Assurance, Risk Management, Utilization Review About the job Experience: •3+ years of experience in quality improvement processes. •3+ years of Utilization Management (UM) experience within the past 10 years. Required Skills: •Acentra Health is looking for a Clinical Quality, Manager to join our growing team. •Ensure that the program meets or exceeds all contract Performance Standards. •In collaboration with Program Director, UM Manager, and clinical supervisors, responsible for the quality monitoring activities including identifying areas of improvement and plan implementation of improvement areas. •Oversee contract-specific Quality Program, providing guidance to the management team and clients regarding quality-related issues. •Focus on risk management, operations and infrastructure, performance monitoring and improvement, and consumer protection and empowerment in the day-to-day management of quality assurance activities for the contract. •Manage program staff Internal Rate of Return (IRR) and clinical documentation audit processes. •Work collaboratively with our client and stakeholders to develop training and process improvements. •Consult with other program managers and supervisors regarding member and/or provider complaints and grievances, as needed. Qualifications: •Bachelor of Science in Nursing degree BSN (MSN preferred). •An active, unrestricted, Colorado Registered Nurse (RN) OR compact state license. •Demonstrated accountability and commitment to high performance, with the ability to work independently and collaboratively to achieve departmental goals. •Knowledge of Utilization Review Accreditation Commission (URAC) standards. •Strong organizational skills with the ability to adapt to change, manage multiple priorities, and meet competing deadlines. •Knowledge and willingness to become a subject matter expert and thought leader for designated program(s). •Demonstrated proficiency in MS Office applications. •Excellent verbal and written communication skills with a strong customer service orientation. Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!