RN Regional Manager, Clinical Services (Must reside in Florida)

Healthmap Solutions•Miami, FL

12h•Hybrid

About The Position

The Regional Manager, Clinical Services plans, directs, and oversees the performance of an assigned team of provider- and member-facing staff. The role oversees administrative, clinical, and quality activities that support strong provider and member engagement and improved health outcomes, with a particular emphasis on provider-facing work. The position is based in Florida and requires moderate travel throughout the state, up to 25%.

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.
Successfully complete the credentialing process.
Excellent verbal, written, and presentation skills.
Ability to develop and maintain strong internal and external relationships.
Ability to multitask, prioritize, and develop 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.
Proficiency in Microsoft Office applications, including Outlook, Word, Excel, and PowerPoint.
Must reside in Florida.

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.
Promote collaboration and communication among multidisciplinary teams to coordinate customer engagement and improve member outcomes.
Monitor key performance indicators (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 monitoring member calls; identify skill and competency gaps and develop ongoing team education.
Develop, coach, and mentor team members to achieve company, department, and individual goals.
Conduct annual performance evaluations and provide constructive feedback, using a positive discipline approach when redirecting team members.
Maintain team performance in accordance with National Committee for Quality Assurance (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.