Clinical Program Director - Redding California

Company: VirtualVocations
Location: Redding, California
Posted On: 05/03/2025

A company is looking for a Clinical Program Director.
Key Responsibilities

Monitor utilization trends and identify clinical drivers of unnecessary inpatient admissions and operational inefficiencies
Design targeted programs to improve medical necessity decision-making and reduce unnecessary inpatient admissions
Define and evolve the clinical framework to ensure alignment with evidence-based guidelines and payer strategic priorities

Required Qualifications

10+ years of experience in inpatient utilization management at a health plan or inpatient revenue integrity at a hospital
Clinical degree (e.g., RN, MD, PharmD) preferred but not required
Proven track record in designing and overseeing clinical programs that impact inpatient utilization and spend
Strong understanding of inpatient utilization, regulatory requirements, and clinical guidelines
Experience collaborating with cross-functional teams to translate clinical strategy into actionable plans More...

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