California Licensed Clinical Director

Job Summary

A company is looking for a Director, Clinical Performance.

Key Responsibilities

• Ensure consistent application of clinical review criteria in authorization and review processes
• Oversee daily utilization management operations, including case review workflows and performance standards
• Collaborate with medical directors on complex cases and participate in internal audits and policy maintenance

Required Qualifications, Training, and Education

• Master's degree in nursing, business, or related healthcare field preferred
• Minimum 10 years of experience in population health management
• Experience managing a remote team
• Experience in program development and management
• Active and unrestricted Registered Nurse (RN) license in California required