Health Services Clinical Manager

We're Hiring a Health Services Clinical Manager to Join Our Team!

• We're seeking a talented and motivated Health Services Clinical Manager to join our team. In this role, you will oversee and manage the day-to-day operations of the Health Services department. This role involves ensuring high-quality member care, managing Health Services staff consisting of clinical and non-clinical staff, and implementing policies and procedures to enhance the efficiency and effectiveness of all clinical services.

Key Responsibilities

Clinical Operations Management:

• Oversee the daily operations of the clinical department, ensuring smooth and efficient workflows. 
• Develop and implement clinical policies and procedures to maintain high standards of care. 

Staff Management:

• Recruit, train, and supervise clinical staff, including nurses, clinical coordinators, and member advocates. 
• Conduct performance evaluations, provide feedback, and facilitate professional development opportunities. 

Member Outreach Quality:

• Monitor and evaluate the quality of member outreach conducted by the clinical team. 
• Implement quality improvement initiatives to enhance member outcomes and satisfaction. 

Compliance and Member Engagement:

• Ensure compliance with all relevant healthcare regulations, standards, and best practices. 
• Perform routine quality chart and call audits to improve member outcomes and drive organizational success. 

Collaboration and Communication:

• Foster effective communication and collaboration among clinical staff, and other departments (Member Experience Team, Shipping, Analytics and Leadership) 
• Serve as a liaison between the clinical team and other stakeholders, including members and their care team, and external partners/supports (Client Partners). 

Technical Support Oversight:

• Oversee clinical team collaboration with technical support to ensure timely resolution of member or system issues. 

Required Qualifications

•  Education: Master's degree in healthcare administration, public health, or related field.
• Experience: 7+ years of leadership in healthcare services, particularly clinical operations, managed care, or population health.
• Knowledge: Familiarity with chronic conditions, NCQA, HEDIS, case management, and utilization management. 

Preferred Qualifications

·        Proficiency in telephonic and remote work environments.

·       Strong care coordination capabilities.

·       Care/Case Management Experience or certifications.

·       Experience in Urgent or Emergent care settings.

·       Leadership and team management skills.

·       Expertise in quality improvement and patient/member care.

·       Knowledge of regulatory compliance.

·       Effective resource management.

·       Excellent communication and collaboration abilities.

·       Oversight of technical support operations.  

Why Join Vheda Health?

At Vheda Health, we invest in our team's wellbeing with a comprehensive benefits package:

·       Compensation: Competitive salary within the published range plus performance bonus and equity opportunities

·       Healthcare: Comprehensive medical, dental, and vision coverage

·       Financial Security: 401(k) retirement plan, voluntary life insurance, short and long-term disability

·       Work-Life Balance: Unlimited paid time off and 12 paid company holidays

·       Community: Engaging team events and activities throughout the year

Base salary range: $68,000–$85,000 per year