Director of Clinical Operations

Description

In an increasingly complex healthcare environment, ICM remains focused on something essential: putting people at the center of every decision. We are dedicated to ensuring that members and health plans feel genuinely seen, heard, and supported throughout their care journey.

We serve clients nationwide with a values-driven approach that blends compassion, clinical expertise, and operational excellence. Our core values: Kindness, Personal Responsibility, a Can-Do Attitude, and Humble Confidence, shape how we work, how we lead, and how we care for those we serve.

As we grow, we welcome individuals who share our belief that healthcare should be effective, compassionate, and truly centered on people.

The Role

We’re seeking an experienced, strategic healthcare leader to serve as our Director of Clinical Operations, a pivotal role responsible for shaping the performance, culture, and future direction of our Utilization Management (UM) and Care Management (CM) programs.

This is more than an operational leadership role. It is an opportunity to elevate clinical quality, drive transformation, and influence how thousands of members experience care. You will partner closely with our VP of Service Delivery & Strategy and Chief Medical Officer to bring clinical strategy to life, ensuring that evidence-based standards become seamless, compassionate operations.

If you are energized by building high-performing teams, strengthening processes, and driving meaningful clinical impact, this role offers the autonomy and visibility to make a measurable difference.

This is a remote role, but we are only considering candidates who reside in Oregon, Washington, Idaho, or Nevada at this time. The position also requires periodic travel to our Portland, Oregon office.

What You’ll Do

As Director of Clinical Operations, you will:

Guide Clinical Teams & Leaders

• Provide daily leadership to UM and CM teams, supporting clinical managers in fostering consistency, engagement, and accountability.
• Champion ICM’s culture and values, ensuring teams feel supported, equipped, and inspired.
  
  

Strengthen Operational Excellence

• Design and refine workflows for efficiency, timeliness, and regulatory compliance.
• Partner cross-functionally with Precertification, Member Engagement, Client Services, and others to ensure a seamless experience across the clinical continuum.
• Establish and track KPIs, leading teams toward measurable improvement.
  
  

Advance Quality & Regulatory Compliance

• Maintain rigorous oversight of policies, procedures, and documentation.
• Collaborate with the Quality Department on audits, performance trends, and targeted interventions.
• Ensure alignment with accreditation standards and evolving regulatory requirements.
  
  

Drive Innovation & Strategic Growth

• Transform clinical strategy into operational practice in partnership with executive leadership.
• Evaluate new tools, processes, and clinical models that improve quality, efficiency, and member outcomes.
• Support program evolution to meet emerging market and client needs.
  
  

Serve as a Clinical Partner to Clients

• Represent clinical operations in client meetings, audits, and implementations.
• Ensure clinical deliverables meet contractual expectations and elevate the client experience.
  
  

Requirements

What You Bring

You’ll thrive in this role if you are a thoughtful, decisive, and forward-thinking clinical leader who believes in balancing compassion with operational excellence.

Required Qualifications

• Active, unrestricted RN license.
• Associate’s or Bachelor’s degree in Nursing.
• At least 8 years of clinical experience, with 3–5 years of leadership experience in Utilization Management, Case Management, or Managed Care (preferably on the payer side).
• Demonstrated success leading clinical teams through growth or operational transformation.
• Strong analytical skills and comfort with clinical and operational data.
• Excellent communication, emotional intelligence, and relationship management.
• Experience navigating complex or sensitive clinical and operational scenarios with sound judgment.
  
  

Preferred

• Experience in a TPA or self-funded health plan environment.
• Leadership experience with remote or geographically dispersed teams.
• Familiarity with EMRs, utilization review software, and medical necessity criteria.
• Certifications such as CCM, CPHM, or CPUR.
  
  

Why Join ICM

People Choose ICM Because They Want To Make a Meaningful Impact. We Blend Clinical Expertise With Genuine Care To Create Supportive Experiences For Both Members And Health Plans. At ICM, You’ll Find

A Mission That Matters

You’ll be part of an organization committed to human-centered healthcare management, where compassion and clinical expertise work hand in hand.

A Values-Driven Culture

Our core values shape how we show up for one another and for the people we serve.

A Remote-First Workplace

Work where you do your best work, with opportunities to connect and collaborate across teams.

Meaningful Work and Real Impact

Every role at ICM contributes to improving health outcomes and strengthening the experience for members and clients nationwide.

Competitive, Comprehensive Benefits

We offer multiple medical plan options (including an HSA plan with employer contributions), dental and vision coverage, company-paid basic life and AD&D, voluntary supplemental coverages, tax-advantaged savings accounts, a 401(k) with employer match, and an Employee Assistance Program with 24/7 support.