Remote Otter LogoRemoteOtter

Director of Health Services - Pacific Southwest Region - Remote

Posted 2 days ago
All others
Full Time
CA, USA
$138,900 - $191,000/year

Overview

The Clinical Director is a key member of the regional clinical leadership team responsible for executing market-level clinical strategy, supporting provider performance, and coordinating with cross-functional teams to drive quality, utilization, and cost-of-care outcomes.

In Short

  • Execute regional clinical strategy and support provider performance.
  • Build relationships with provider group leaders.
  • Drive improvements in patient experience and operational excellence.
  • Monitor key performance indicators and identify trends.
  • Implement regional pilots and vendor-supported programs.
  • Ensure compliance with clinical policies and quality standards.
  • Collaborate with analytics and finance teams.
  • Facilitate provider education and remediation efforts.
  • Participate in governance committees.
  • Travel up to 30-35% in the Pacific Southwest region.

Requirements

  • Clinical degree with active unrestricted license (e.g. RN, NP).
  • 5+ years of experience in clinical operations or care management.
  • 5+ years experience in managed care industry.
  • Strong understanding of value-based care and quality metrics.
  • Proficiency in monitoring clinical and financial data.
  • Ability to manage cross-functional projects.
  • Excellent written and verbal communication skills.
  • Preferred experience in both provider and payer roles.
  • Prior executive level role with a successful track record.
  • Advanced degree in business or population health preferred.

Benefits

  • Health benefits effective day 1.
  • Paid time off and holidays.
  • 401(k) retirement savings plan with employer match.
  • Tuition assistance and scholarships for dependents.
  • Parental and caregiver leave.
  • Employee charity matching program.
  • Career development opportunities.
  • Recognition pay.
  • Flexible benefits packages.
  • Travel reimbursement for occasional office visits.

Go365

Go365

004 Humana Insurance Company is dedicated to putting health first for its teammates, customers, and the communities it serves. As a leading provider of insurance and healthcare services, Humana focuses on improving the quality of life for millions of individuals, including those with Medicare and Medicaid, families, and military personnel. The company emphasizes a holistic approach to well-being, offering a range of benefits designed to support personal wellness and smart healthcare decisions. Humana is committed to fostering an inclusive workplace and actively promotes equal opportunity for all employees.

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