Clinical, Supervisor - RN - Full-time (Remote U.S.)

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Acentra Health is looking for a Clinical, Supervisor - RN - Full-time (Remote U.S.) to join our growing team. Job Summary: As the Clinical Supervisor – RN – Full-time (Remote U.S.), this individual plays a pivotal role in overseeing and managing the Utilization Management (UM) activities within the organization. With a strong clinical foundation and leadership acumen, the Clinical Supervisor ensures that UM processes are executed efficiently, consistently, and in alignment with regulatory and contractual standards. A key focus of the role is to uphold excellence in clinical programs, fostering continuous improvement and innovation in care management practices. Additionally, the Clinical Supervisor is instrumental in cultivating and maintaining strong relationships with customers and stakeholders, ensuring that service delivery meets or exceeds expectations and contractual obligations. The Clinical Supervisor will also have oversight of direct reports. The Clinical Supervisor and direct reports are expected to work Monday through Friday, with participation in a rotating schedule that includes weekends and holidays.

Lead and oversee all Utilization Management (UM) activities including prior authorization and retrospective reviews, ensuring accuracy, consistency, and timely completion. Conduct utilization reviews as needed to support workload demands and program requirements. Monitor daily work queues and adjust staffing schedules to align with departmental demands. Evaluate productivity and performance metrics of nurse reviewers to maintain high standards of efficiency and quality. Identify onboarding and ongoing learning needs for Clinical Reviewers; collaborate with leadership to design and implement effective development plans. Actively participate in leadership meetings, committees, and cross-functional workgroups to promote shared decision-making and continuous improvement. Oversee quality assurance activities such as audits, Quality Improvement Plans (QIPs), database management, and Inter-Rater Reliability (IRR) support. Identify areas for process and clinical improvements; develop and execute action plans to enhance outcomes. Serve as a liaison to customers and providers, ensuring timely resolution of issues and promoting service excellence. Stay current with clinical best practices and UM protocols, act as the primary resource for nurse reviewers regarding clinical review inquiries. Support departmental and organizational goals by performing additional duties as assigned. Read, understand, and adhere to all corporate policies, including policies related to HIPAA and its Privacy and Security Rules. The above list of responsibilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary.