RN Leader (Medical Management)

Morgan Consulting Resources, Inc. has been retained to conduct the search for a Clinical Operations Leader (RN). This is an outstanding opportunity to be an integral member of a dynamic organization, AllCare IPA based in Modesto, CA. This position will be based onsite in Modesto. About the Organization: Established in 1989, AllCare Independent Physician Association (IPA) is a strategic, forward-thinking physician organization committed to delivering high-quality care while driving operational excellence, financial performance, and sustainable growth. With more than 1,259 contracted physicians, AllCare IPA has earned a strong reputation as an innovative and respected organization serving physicians and patients throughout San Joaquin, Stanislaus, and Merced counties. At the heart of AllCare IPA’s success is a culture built on collaboration, stability, and long-term relationships. Their 316 employees are part of a team where their ideas and contributions are valued, bureaucracy is kept to a minimum, and individuals are empowered to make a meaningful impact. They take pride in fostering an environment where employees can build rewarding careers while enjoying excellent benefits, supportive leadership, and a strong sense of purpose. For more information see: About the Position: Reporting to the CEO, the Clinical Operations Leader (RN) oversees a team of approximately 24 nurses and clinical support staff and is responsible for the strategic oversight, operational performance, and regulatory integrity of the organization’s medical management functions within a delegated, capitated managed care environment. This role will be a good fit for RN leaders with: Health plan or provider/medical group experience; CA managed care background; Knowledge of delegated models; Knowledge of CMS and DHCS regulatory expectations; and Knowledge of UM, CM, HEDIS/STARS performance initiatives and physician engagement strategies. Education and Experience: Current, unrestricted RN license and eligibility to obtain California RN licensure if not already licensed in the state. 5-7 years of clinical and healthcare management experience including in the acute hospital setting. Minimum of 5-7 years of clinical management experience in California delegated capitated IPA, medical group, health plan, or managed care organization, including management of nursing and operations staff. Strong knowledge of California managed care regulations in a risk-based environment. Experience interacting with CMS, DHCS, NCQA, and health plan delegation. #J-18808-Ljbffr