Regional Manager, Clinical Services (Located in state of Florida)

Healthmap Solutions

26d•$100,855 - $152,585•Hybrid

About The Position

The Regional Manager, Clinical Services plans, directs, and oversees the performance of assigned provider- and member-facing staff. The role oversees administrative, clinical, and quality activities that support provider and member engagement and improved health outcomes. Located in Florida, the position involves limited travel scheduled according to business needs.

Requirements

Bachelor's degree in healthcare or a related field.
Active, unrestricted RN license.
At least 3 years of progressive supervisory and/or management experience.
At least 5 years of progressive experience in healthcare services, clinical operations, quality, or care management.
Valid and unrestricted driver's license.
Ability to successfully complete the credentialing process.
Excellent verbal, written, and presentation skills.
Strong interpersonal skills to develop and maintain internal and external relationships.
Ability to multitask, prioritize, and create solutions in a challenging environment.
Demonstrated leadership skills and ability to create and maintain a positive work environment.
Strong critical-thinking and analytical skills.
Ability to foster strong employee engagement among the team.
Proficiency in Microsoft Office, including Outlook, Word, Excel, and PowerPoint.

Nice To Haves

Master's degree.
At least 5 years of experience closing care gaps or coordinating care.
Prior experience building and managing relationships with healthcare providers or patients.

Responsibilities

Represent the organization as an ambassador to internal and external customers.
Collaborate with the team to engage providers and members and serve as an escalation point for difficult practices or members.
Implement organizational policies, procedures, workflows, and action plans to drive team performance.
Support communication and coordination among multidisciplinary teams to improve customer engagement and member outcomes.
Monitor KPIs, identify trends and opportunities, and develop action plans or remediation strategies.
Develop, monitor, and report on team performance and productivity.
Troubleshoot technical issues as needed.
Promote continuous improvement through team audits, provider practice visits, and member-call monitoring; develop ongoing team education to address identified opportunities.
Develop, coach, and mentor team members to achieve company, department, and individual goals.
Conduct yearly performance evaluations and provide constructive feedback, using a positive discipline approach when redirecting team members.
Maintain team performance in accordance with NCQA standards, including appropriate provider and member documentation.
Comply with HIPAA privacy laws, other federal and local regulations, and company security policies.
Recommend operational adjustments to leadership to help meet organizational objectives and goals.
Perform other related duties as assigned.