Clinical Operations Manager

Job overview

The Clinical Operations Manager is a hybrid role in Klamath Falls, OR. Compensation is not specified. The position manages clinical operations, including medical and dental authorizations and care coordination for members. The manager oversees utilization review and care coordination processes to support timely, appropriate, and cost-effective services. The role works with clinical leaders, providers, and other departments to coordinate care, meet regulatory and contractual requirements, and improve outcomes and resource use.

What you'll do

• Manage medical and dental utilization review
• lead contract deliverables and compliance for utilization management and care coordination
• identify members with complex needs
• oversee care coordination across settings and authorization processing
• review level and quality of care
• collaborate on complex cases
• monitor high-cost utilization and interventions
• support transitions between care settings and plans
• participate in provider and department meetings
• support quality improvement and maintain procedures
• comply with HIPAA.

What we're looking for

Skills & competencies

clinical operations manager

utilization management

care coordination

medical authorizations

dental authorizations

hybrid

klamath falls or

cascade comprehensive care

oregon rn license

case management certification

medicaid

hipaa

Work arrangement

• Weekend coverage required

Benefits & perks

• Vacation
• medical, dental, and vision insurance
• 401(k) pension plan.

Why this role

Requires an Oregon Registered Nurse license and a Certified Case Manager certificate or equivalent within 18 months.

About the employer

Cascade Comprehensive Care Inc is hiring for this role. Industry: HMO Medical Centers. Sector: 62.