Director of Clinical Services

Welcome to Arkos Health As a company, we are rethinking how healthcare works by partnering with primary care providers to close quality gaps, coordinate care and keep patients healthy, while staying out of the hospital. We are a start up company, which allows us to move quickly, build as we go, and learn by doing.

We are a value-driven organization delivering innovative solutions to payors and providers through a combination of proprietary technology and integrated care services - including in-home, virtual and in clinic care. Our focus is supporting health plans and provider groups in managing their most complex and high-cost patient populations. Operating across multiple regions, our mission is to become the most trusted and impactful partner to health plans, healthcare service providers and the communities we serve.

We are currently in Arizona, Nevada, North Dakota, Illinois, Vermont, Montana, and Wyoming Our goal is to be the most valued partner to health plans, service providers, and the community we collectively serve.

What's in it for You?

• Great Benefits
• Employer-paid Medical, Dental and vision premiums at no cost to you
• Employer-paid Short-Term Disability premiums at no cost to you
• Employer-paid Life Insurance premiums at no cost to you
• Employer matching 401(k)
• 15 days annual combined sick/vacation and 10 days of holiday during your first year
• Your Birthday off
• We have great people and a growing culture From coffee bars to Ice Cream Day, we recognize our team
• We are ranked as the 113th fastest-growing private company in the United States and 11th within the healthcare services sector on the 2024 Inc. 5000 list Join us today

How You'll Make a Difference:

Arkos Health is seeking a Director of Clinical Services. The Director of Clinical Services reports directly to the VP of Clinical Services and provides day-to-day oversight and adherence to all standards and expectations of the Clinical teams.

Essential Duties and Responsibilities:

• Provide supervision and guidance through clinical leadership to the care management teams
• Maintain and ensure the successful process flow of all clinical programs established with our contracted partners
• Provide oversight and ongoing training to care management clinicians
• Establish and evaluate operational/staffing criteria for Clinical Service departments including but not limited to Complex Care Management, and Hospital/SNF Care Management
• Interact proactively with network providers/offices to educate on organization services, problem solve and resolve care management/care coordination related issues or concerns
• Identify and submit to the Chief Clinical Officer any potential quality issues for review
• Prepare and investigate any quality issues or complaints involving the clinical team
• Collaborate with the clinical team for process improvement and assurance of operational quality as well as, HIPAA compliance according to corporate and compliance policies
• Conduct weekly audits of care management team cases, to ensure corporate and partner compliance is met
• Prepare and appropriately delivery weekly Interdisciplinary Care Team agenda and participates in meetings according to contracted standards
• Maintain and audit weekly time and mileage sheets for all applicable staff
• Act as a resource for all clinical staff for any operational or clinical concerns
• Conduct performance evaluations and formulates disciplinary action plans, as appropriate
• Participate and equally shares in after-hour and week-end coverage for Clinical Services Department
• Work with the assigned HR team to conduct recruitment, hiring, and training of required personnel
• Strong teamwork philosophy and willingness to accept change proactively

Qualifications/Skills:

• BSN required; MSN preferred
• Current, unencumbered, Registered Nurse License and graduation from an accredited Registered Nurse program
• Current unrestricted Nursing license
• Knowledge of Medicare, Medicaid, Marketplace, state, and local managed care regulations
• Five years of acute care or care management experience, prior ER or ICU or other relevant clinical role requiring quick critical thinking experience preferred
• Must have the ability to present clinical information both accurately and confidently
• Able to communicate effectively and in a professional manner with all levels of internal staff and external customers
• Ability to be detail-oriented, able to function under pressure and able to prioritize and re-prioritize tasks as needed
• Ability to work both independently and as part of a team, with minimal supervision
• Excellent customer service and communication skills, both oral and written
• Prior experience in managed care setting preferred

Must complete our Culture Index Survey. Take the assessment at . This is not a pass/fail test and does not measure intelligence.

Arkos Health EEO Statement:

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.

Arkos Health is a drug-free workplace. All job applicants selected for employment are required to submit to a pre-employment drug test and background check.

Arkos Health participates in E-Verify to confirm eligibility to work in the United States. To view the details on this program, visit our career page at Careers - Arkos Health