Clinical, Supervisor - RN - Full-time (Remote U.S. within Alaska Time Zone Hours)

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 within Alaska Time Zone Hours) to join our growing team. Job Summary: The Clinical Supervisor (RN) role will oversee and manage the Utilization Management activities. The primary focus is to maintain high standards in clinical programs and enhance customer relationships to ensure contract requirements are met successfully. PLEASE NOTE: * This role is contingent upon being awarded a contract. Start dates and final offers are contingent upon the contract award and final contract start dates. *

Manage and oversee Utilization Management (UM) activities. Ensure overall consistency, thoroughness, and accuracy of clinical programs. Oversee program to ensure clinical efficiencies, deliverables, and contract functions meet high standards. Strengthen relationships with customers and meet contract requirements. Provide day-to-day oversight to manage the utilization review program. Responsible for utilization reviews as defined by the contract to include prior authorization and retro reviews. Serve as a Subject Matter Expert (SME) and works with other Service Authorization (SA) nurses to ensure the appropriate, effective, and cost-efficient use of healthcare services for Medicaid beneficiaries. Evaluates SA requests for medical services to ensure they meet the criteria for medical necessity. Participate as a team member fostering collaborative decision-making among leadership, committees, teams, or work groups of diverse composition. 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 from time to time.