Director of Clinical Operations and Strategy

Category: Insurance

Location:

Aquarius Strategies has been retained to recruit TheDirector of Clinical Operations and Strategy. This individual serves asa key clinical and operational leader, for a trusted, established company, reportingdirectly to the Vice President of the Division. The role is responsible forshaping, advancing, and scaling this organization’s IME, Review Services, CaseManagement, and managed care service lines. A critical function of thisposition is to provide clinical guidance to ensure the delivery ofhigh-quality, evidence-based services across all business lines, but with afocus on Case Management Services. The Director drives client satisfaction,retention, and revenue growth, by developing innovative clinical programs,optimizing operational performance, and expanding service capabilities acrossdiverse markets, specialties, and business lines. The ideal candidate brings astrong blend of clinical expertise, strategic vision, and operationalleadership to achieve impactful outcomes and advance organizational goals.

Requirements

EssentialDuties and Responsibilities:

• Developand execute clinical strategies that support organizational growth, enhanceworkflows, and strengthen clinical operations and staffing models across IME,Review Services, Case Management, and managed care service lines.
• Design,implement, and evaluate new clinical programs that improve outcomes andmaximize value for clients across diverse markets and specialties.
• Provideclinical guidance to ensure the delivery of high-quality, evidence-basedservices and compliance with clinical standards and regulatory requirements.
• Identifyareas of client or employee dissatisfaction and implement targeted solutions toelevate the customer and workforce experience.
• Partnerclosely with operations, business development, and cross-functional teams tostreamline processes, improve efficiency, and support revenue objectives.
• Identifyand support collaborative selling opportunities to expand service utilizationand client engagement.
• Lead,mentor, train and inspire nursing and clinical teams to achieve highperformance and professional growth.
• Overseeclinical recruitment strategies, including interviewing, hiring, onboarding,and performance development planning.
• Establish,monitor, and ensure compliance with quality initiatives, clinical standards,and regulatory requirements.
• Leveragedata and analytics to identify trends, educate clients, and drive continuousimprovement in program outcomes.
• Conductregular performance reviews, coaching sessions, and leadership developmentactivities for clinical staff.
• Performother duties and responsibilities as assigned

Competencies:

• Proven ability to design andarticulate business plans/business models, program design, business/salesproposals and implementation plans.Solicits input from others and transitions concepts into strategic,tangible plans, products, and services
• Provenability to analyze a business situation quickly from many perspectives and tocreate well-reasoned solutions.Must bea conceptual thinker, able to recognize problems from few or subtle clues andbe innately comfortable with complexity
• Mustbe able to foster strong working relationships and credibility quickly at alllevels of the organization Able to create a partnership atmosphere withinternal and external resources while achieving key operating objectives
• Mustbe able to balance risk taking and judgment, aggressive and confident.
• Exceptionalverbal and written communication skills, including strong presentationcapabilities.
• Advancedanalytical and interpretive skills with the ability to translate data intoactionable insights.
• Proficiencyin Microsoft Office and related business tools.
• Experiencewith operational platform development, workflow optimization, and workforceefficiency initiatives.
• Strongorganizational, interpersonal, and relationship-building abilities.
• Skilledin negotiation, facilitation, and conflict resolution.
• Deepknowledge of IME, Review Services, Case Management, workers’ compensation,liability, and disability claims management.
• Strongunderstanding of client service principles, including marketing and salescollaboration with internal and external stakeholders.
• Abilityto excel in a fast-paced environment and consistently exceed performanceexpectations.

Educationand/or Experience: (includescertificate & licenses)

• Bachelor’s degree in nursing required; active Registered Nurse withCompact License.
• Minimum of 10 years of leadership experience in IME, Review Services,Case Management, clinical operations, claims, or managed care.
• Workers Compensation experience required.
• Demonstrated success in developing new service lines and expandingprogram volume and geographic reach.
• Proven ability to lead nursing programs, execute business strategy, anddeliver measurable results.
• Strong background in service innovation, talent development,accountability, and building high-performance cultures.
• Experience collaborating with executive leadership and sales teamsduring program development and launch.
• Experience supporting business capture efforts, including proposaldevelopment and bid processes.
• Certified Case Manager (CCM) preferred.

Benefits

Details

Originally posted on Himalayas