Manager Clinical Support

Texas Children's Medical Center • Houston, TX

11h

About The Position

We are searching for a Manager of Clinical Support. This position is responsible for assisting with the interpretation of federal, state, and other regulations and requirements related to all Medicaid products, and coordinating/providing the necessary reporting requirements in a timely manner. Responsibilities include direct and indirect supervision or clinical and non-clinical team members. Think you've got what it takes?

Requirements

• Bachelor's Degree in Nursing required
• RN - License-Registered Nurses from Texas Board of Nursing or Nurse Licensure Compact required
• 4 years Business Operations in a Healthcare or Insurance Environment, or Nursing Managed Care experience required

Nice To Haves

• Management/Leadership experience preferred

Responsibilities

• Develops strategies, policies, and procedures to ensure regulatory compliance.
• Ensures appropriate communications and partners with others both within and across teams to accomplish goals.
• Provides data and reporting on productivity and other metrics.
• Develops and implements process improvement initiatives, both clinical and non-clinical.
• Ensures quality calls and key performance metrics are met and adhered to according to any internal or external requirements for the call center.
• Manage the Quality of the Care Coordination Team at the Health Plan using nursing/clinical knowledge
• Manage and oversee the actions taken as the result of audits and/or member complaints, ensuring appropriate actions are taken.
• Ensure the timely and accurate completion of all state reporting requirements for Care Coordination quality reporting.

What This Job Offers

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