Clinical Operations Manager- Care Management

Clinical Operations Manager- Care Management Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.

Overview

Job title: Clinical Operations Manager- Care Management Sagility is a global leader specializing in augmenting healthcare teams to better patient, member, business and financial outcomes in partnership with payers and providers. A leader who can interact closely with members and patients to deliver evidence-based, timely, preventative, personalized, cost-effective care with focus on the whole person that improves health, value and overall quality of life. We are currently hiring an Clinical Operations Manager- Care Management to join our team.

Responsibilities

• Monitors daily all areas of performance metrics (call handling times, service levels & quality grades) to assure that standards are met across the board referring to a database, a program or reports.
• Administers program and implements both client and in-house policy.
• Ensures operations are managed on a day-to-day basis.
• Attends client meetings regularly to discuss program performance based on key operational metrics.
• Interfaces with clients during visits, presents program performance when needed, and escalates issues that are out of the ordinary.
• Attends weekly operations review and presents action plans to address issues.
• Collates and responds to operational issues reported by Team Leads – as needed.
• Escalates operational issues beyond level of authority to the Department Head – as needed.
• Informs the Department Head when system needs arise (system errors/downtime) to handle calls effectively – as needed.
• Submits weekly and monthly ops review reports to the Department Head.
• Minimizes or manages customer complaints to an acceptable level.
• Works with the Department Head to develop the program and implement policy – as needed.
• Collaborates with Team Leads and Support Managers with other groups to develop programs that further develop the associates.
• Recommends new or modifications to existing procedures to ensure Continuous Process Improvement (CPI).
• Evaluates management and contact center practices for potential modifications to improve employee efficiency and satisfaction.
• Responsible for development and implementation of policies and procedures pertaining to HIPAA and ensures compliance with Privacy Rules Standards.
• Ensures Operations Team meets productivity standards daily.
• Provides daily leadership and motivation to the Operations Team.
• Conducts monthly one-on-one coaching with direct reports and provides feedback to drive performance and reduce cost using data from attendance, handling time, productivity and quality reports.
• Devises strategic communication plans to relay changes on time and accurately.
• Creates incentives for staff in alignment with performance targets.
• Conducts weekly meetings with direct reports to discuss team and program performance, issues and share best practices.
• Designs development plans for direct reports and prepares for succession planning.
• Initiates and supports employee satisfaction and workplace programs.
• Advises on personnel/program issues to the Department Head for decision-making.
• Coordinates with client for login ID upgrades due to promotion or deletion of network IDs related to attrition.
• Spot-checks agents on customer handling and provides feedback to TLs/Quality personnel with areas for improvement.
• Performs tasks assigned by the Department Head.
• Prepares composite reports from subordinate reports.
• Communicates with other departments about operational and personnel issues.
• Handles overall project budgeting, financials, strategies to improve KPIs, single point of contact for client relations, project profitability, planning and process improvements.

Education & Qualifications

• Any Nursing 4-year college degree, and/or associate degree, and/or equivalent experience.
• 5 years clinical experience.
• 2 years managerial experience.
• Preferred experience: 2 years customer service.

Benefits

• Medical
• Dental
• Vision
• Life Insurance
• Short-Term and Long-Term Disability
• Flexible Spending Account
• Life Assistance Program
• 401K with employer contribution
• PTO and Sick Time
• Tution Reimbursement

Join our team, we look forward to talking with you! An Equal Opportunity Employer/Vet/Disability Location: Work@Home USA, United States of America Seniority level

• Not Applicable

Employment type

• Full-time

Job function

• Management and General Business

Industries

• Outsourcing and Offshoring Consulting

Note: This listing may include additional context or related postings. If you are interested, refer to Sagility’s careers page for the latest updates. #J-18808-Ljbffr Apply tot his job Apply To this Job