• Clinical Quality Manager

    Requisition ID
    # of Openings
    US-CA-Santa Monica
  • Overview

    At Advanced Medical Reviews, we believe every patient should receive quality healthcare.


    Based in Santa Monica, Advanced Medical Reviews (AMR) is an Independent Review Organization that is setting the industry standard in providing quality independent medical case review and utilization management services. At AMR, we guarantee the highest quality standards throughout the review process. Our commitment is to our clients and their patients. We emphasize continuous quality improvement, innovation and client satisfaction.


    The Clinical Quality Manager is responsible for innovating and managing quality initiatives as well as providing direction and support to the company with the goal of promoting high quality reviews and enhancing our case review process. This individual thrives in a dynamic, fast-paced environment like AMR’s and has a strong desire to build a values-oriented workplace. This position provides clinical/quality support across departments in both internal and external facing capacities. The ideal candidate has an innovative spirit and is constantly looking for ways improve and promote quality.


    We are open to a full or part time remote team member. Dedicated part-time schedule may be considered.


    Overview of Responsibilities:

    • Directly supervise and develop clinical QA staff.
    • Review and analyze quality assurance data to create improvement strategies that will ensure the highest quality product is achieved.
    • Project manage various quality initiatives from strategy and planning to execution and oversight.
    • Support Sales/Account Management team in promoting our product and addressing client specific quality needs, including direct client interfacing.
    • Provide clinical/quality support to operations to ensure successful launch of new clients, services, business lines and improve clinical and non-clinical case processing.
    • Provide support to internal clinical and non-clinical staff, physician reviewers, and clients; responding to and resolving current situations and strategizing to proactively address concerns.


    Position Requirements:

    • Bachelor’s or higher level degree in nursing or medical field.
      • Active license not required.
    • Prior experience with and knowledge of the insurance industry, preferably claims management, case review, or utilization management, is required.
    • Employee management experience is required; demonstrated ability to lead and develop direct reports.
    • Ability to effectively interact with internal and external staff from a variety of backgrounds (e.g. clinical and non-clinical staff, physicians, high level client executives) and adapt communication appropriately.
    • Demonstrated project management and leadership capability.
    • Excellent written and verbal communications skills.






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