Health Services Clinical Manager

Vheda Health • Columbia, MD

21d • $68,000 - $85,000

About The Position

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.

Requirements

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

Nice To Haves

• 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.

Responsibilities

• 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.
• Recruit, train, and supervise clinical staff, including nurses, clinical coordinators, and member advocates.
• Conduct performance evaluations, provide feedback, and facilitate professional development opportunities.
• Monitor and evaluate the quality of member outreach conducted by the clinical team.
• Implement quality improvement initiatives to enhance member outcomes and satisfaction.
• 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.
• 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).
• Oversee clinical team collaboration with technical support to ensure timely resolution of member or system issues.

Benefits

• Competitive salary within the published range plus performance bonus and equity opportunities
• Comprehensive medical, dental, and vision coverage
• 401(k) retirement plan, voluntary life insurance, short and long-term disability
• Unlimited paid time off and 12 paid company holidays
• Engaging team events and activities throughout the year

What This Job Offers

• Job Type: Full-time
• Career Level: Manager