Executive Director Clinical Review UM Operations

This outstanding organization in the Portland Oregon Area is actively interviewing for a Executive Director to lead the Clinical Review Operations. Join this established health management organization, and help support a huge group of stakeholders across the Western U.S.

Established over 20 years ago, this Medical Management organization offers comprehensive tools and services to a wide range of healthcare participants including independent physicians, medical groups, hospitals, ambulatory centers, clinic networks, health plans, and payers. The Executive Director of Operations will oversee Clinical Review and Utilization Management (UM) processes in direct support of these lines of business, and will play a significant role in the operations of this company.

Reporting to the Chief Operations Offer, the Executive Clinical Review and UM Director will lead an outstanding team in support of the company’s mission of driving high-quality and patient focused healthcare. Supporting the Exec. Director is a Clinical Review Manager who oversees a team of remote and onsite medical review specialists, and a Utilization Management Manager, who leads a team of Nurses who review and prepare UM requests.

The Executive Director will play an integral role in the Operations of both Clinical Review and Utilization UM processes through engaging a broad array of communication channels. This person should feel comfortable with managing a distributed team, and able to maintain efficiency through virtual leadership. Additionally, LEAN transformation experience in Payer organizations will be a strong marker for the skills needed to be successful.  

Strong clinical, management, and leadership experience will be needed for the Executive Director of Clinical Review and UM. This person will work on a cross-functional team to develop, deploy, and drive operations for a Medical Review product and a Utilization Management product, both of which are used by hundreds of customers. The Executive Director will take responsibility for the overall efficiency and management of programs that have helped thousands of clients get their processes back on track.

The Greater Portland Area is quickly becoming one of America’s prime destinations, and it’s easy to see why. The UM and Clinical Review Executive Director will discover an affordable cost-of-living, close proximity to some of the country’s best schools, and a growing economy, making this region a great place to think about family. World-class cuisine, a legendary music scene, a nationally recognized craft beer and cocktail industry, and a long history of artistic culture will keep the city folks happy to the core. A short trip in any direction puts you square in the middle of the most beautiful nature the West Coast has to offer. From the snowy slopes of Mt. Hood, the rocky Oregon Coast, the outdoorsy type will find plenty to keep them happy.

Executive Director will play a vital role in the operations of this medical management organization, and in the support of the customer / patient community. In support of this large task, you will receive a generous benefits package and competitive compensation.