Manager of Clinical Business Operations
About The Position
VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years. The Manager of Clinical Business Operations ensures Utilization Management non-clinical operations meet CMS and NYSDOH requirements while supporting departmental quality assurance and business objectives. Reporting to the Director of Utilization Management, you will guide non-clinical staff performance, translate regulatory expectations into workable processes, and help drive consistent, audit-ready outcomes.
Requirements
- 3+ years in Utilization Management/Managed Care with Medicare/Medicaid UM quality monitoring and regulatory processes (non-clinical)
- Strong leadership, communication, and stakeholder-management skills
- Ability to analyze data, measure outcomes, and escalate action plans
- Comfort working quickly, prioritizing effectively, and meeting deadlines
- Strong computer/software proficiency
Nice To Haves
- Bachelor's degree preferred
Responsibilities
- Monitoring non-clinical productivity and deliverables
- Supporting utilization management projects and departmental initiatives tied to regulatory alignment
- Developing and updating policies and communicating operational impacts to upstream and downstream stakeholders
- Providing administrative subject matter expertise
- Contributing to corrective action plans
- Identifying operational risks and partnering on mitigation plans
- Supporting additional initiatives as directed
- Reviewing dashboards and recent outputs to confirm non-clinical work is tracking to expected standards
- Connecting with team members to remove blockers and reinforce consistent documentation practices
- Interpreting new or updated CMS/NYSDOH guidance, translating it into clear internal messaging, and aligning timelines with partners who depend on UM operational outputs
- Joining working sessions to calibrate monitoring approaches, draft or refine policy language, and prepare concise summaries that clarify downstream impacts
- Coaching and developing staff through targeted feedback and short learning touchpoints
- Consolidating observations into practical recommendations for leadership, ensuring issues are surfaced early and next steps are well-defined
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What This Job Offers
Job Type
Full-time
Career Level
Manager
