Manager Health Plan Clinical Operations RN

Trinity Health • Fresno, CA

3d • Onsite

About The Position

This position manages the activities of the Health Plan Clinical Services Team to ensure the achievement of department and company goals. The Clinical Manager will be responsible for overseeing the day-to-day clinical operations of the health plan, including patient care, staff management, and maintaining quality standards. Responsibilities include managing the performance of the team in accordance with the Upstream Health Plans Utilization and Quality Programs. Providing oversight and support to ensure overall outcomes and optimal Utilization Management and Quality performance.

Requirements

• Current licensure as a Registered Nurse in the State of California is required. Clinical professionals currently licensed outside the State of California will be provided six (6) months from date of hire to obtain equivalent California state licensure.
• Bachelor's Degree is required.
• Two (2) years of management experience is required.
• Ability to communicate effectively with patients, families, and health care personnel and ability to lead, direct, and mentor personnel is required.

Nice To Haves

• Three years of Nursing Leadership experience may substitute for the Bachelor's Degree requirement.
• Health Plan experience preferred.

Responsibilities

• Manages the activities of the Health Plan Clinical Services Team to ensure the achievement of department and company goals.
• Oversees the day-to-day clinical operations of the health plan, including patient care, staff management, and maintaining quality standards.
• Manages the performance of the team in accordance with the Upstream Health Plans Utilization and Quality Programs.
• Provides oversight and support to ensure overall outcomes and optimal Utilization Management and Quality performance.

What This Job Offers

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