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