Regional Director of Clinical Ops & Case Coor
$135,000–$150,000 year
On-siteNew Jersey, United States
Job Summary
Lead clinical operations and quality improvement initiatives across Ponos Care programs, aligning strategies with value-based care objectives and organizational performance goals. Oversee clinical workflows, monitor HEDIS and NCQA metrics, and implement corrective action plans to address performance gaps while ensuring compliance with federal, state, and payer regulatory requirements. Provide leadership and mentorship to Nurse Managers and clinical supervisors, fostering interdisciplinary collaboration and supporting the implementation of scalable clinical programs and innovative care delivery models. Collaborate with executive leadership and data analytics teams to enhance reporting insights and support continuous improvement initiatives that improve patient outcomes and operational effectiveness.
Required Qualifications
- Bachelor's degree in Nursing, Healthcare Administration, Public Health, or related field
- 7+ years experience in clinical operations, quality management, or healthcare leadership
Desired Qualifications
- Master's degree preferred (MSN, MHA, MPH, MBA)
- Active RN license preferred
- Experience with HEDIS, NCQA, Medicaid, or value-based care models preferred
- Experience in home health, managed care, or population health environments preferred
- Strong understanding of regulatory compliance and clinical performance standards
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