Los Angeles, California
Bridgewater, New Jersey
Posted: 19-Nov-25
Location: Los Angeles, California
Categories:
Internal Number: 149892831
We are seeking a highly skilled and dynamic Director of Clinical Services to lead the development, evaluation, and implementation of multiple clinical programs and medical services with an emphasis on optimizing Utilization Management for the Faculty Practice Group (FPG) Management Services Organization (MSO). Reporting to Chief Medical Officer of Faculty Practice Group and Medical Group, this role is pivotal in ensuring the delivery of program functionalities in all aspects of Utilization Management and its integration with other patient facing programs within the MSO. You will oversee and direct key initiatives, ensuring that MSO members enrolled in various health plans receive high-quality, integrated care.
You will:
- Oversee the development and execution of multiple UM processes and workflows, while continuously identifying and evaluating areas for improvement and potential innovations to be implemented
- Oversee the development and execution of needed points of integration aimed at enhancing healthcare delivery for MSO members.
- Ensure seamless integration of various clinical functions with Utilization Management, such as Case Management, Quality Improvement, Credentialing, and Health Plan Relations to improve overall healthcare services and control healthcare costs.
- Collaborate with internal and external stakeholders to ensure cohesive and effective program delivery, while supporting value-based care initiatives.
- Build and maintain strong relationships with key stakeholders, including members, health plans, and clinical teams, to ensure the effective execution of health programs and services.
- Direct and mentor staff members, ensuring clear communication, effective teamwork, and high-performance standards.
Salary Range: $144,400 - $341,800/annually
We’re seeking an experienced leader with:
- A Registered Nurse License, Advanced Practice Provider (Nurse Practitioner or Physicians’ Assistant), or equivalent
- Bachelor’s degree in relevant discipline, required
- Master’s degree in relevant discipline, highly desired
- 3-5 years of experience in a clinical capacity (RN, APP, etc.), required
- 3-5 years of executive leadership experience with a focus on Utilization Management for a medical group, IPA, or Health Plan, required
- In-depth understanding of managed care, MSO functions, and population health services, required
- Experience and successful achievement of healthcare MSO certification and recognition programs
- Strong communication skills with all levels of staff and stakeholders
- Ability to navigate and perform duties within a complex, matrixed organization
- Leadership capabilities that demonstrate openness to change and the ability to implement innovative programs that align with strategic initiatives
- Exceptional interpersonal, written, and verbal communication skills
- Proficiency in Microsoft Office applications (Word, Excel, PowerPoint)
- Ability to function independently with sound judgement in decision-making and take initiative when needed while appropriately soliciting input or advice
