Position Description

The Clinical Operations Manager is a member of the Nursing and Clinical Operations leadership team responsible for leading people, programs, workflows, and operational performance across assigned clinical service lines.

This role requires a strong operational leader who can evaluate complex processes, identify opportunities for improvement, design and implement scalable workflows, and collaborate across business functions to improve patient, provider, and organizational outcomes.

The position will have significant responsibilities for Behavioral Health (BH) operations, while also supporting broader initiatives and programs. Previous experience within behavioral health, care coordination, case management, social work, nursing, or a related healthcare environment is strongly preferred; however, the candidate's ability to lead operations, develop programs, improve processes, manage change, and drive measurable results is paramount.

Essential Job Functions

• Operational Leadership: Lead assigned clinical operations programs and teams, ensuring effective day-to-day execution while identifying opportunities to improve performance, quality, efficiency, and scalability.
• Behavioral Health Operations: Provide operational leadership for BH programs and workflows including care coordination, referrals, patient and provider support, and other activities across the BH continuum.
• Process and Workflow Design: Support the design, implementation, and ongoing management of clinical programs including development of workflows, procedures, performance measures, escalation pathways, and operational controls.
• People Leadership: Lead, mentor, and develop clinical and operational team members through coaching, performance management, goal setting, professional development, and accountability.
• Cross-Functional Collaboration: Partner with Behavioral Leaders, Nursing, Medical Affairs, Operations, Product, Tech
• Continuous Improvement: Apply critical thinking, data, and operational expertise to identify root causes, eliminate unnecessary manual work, and develop sustainable solutions.
• Performance Management & Analytics: Establish, monitor, analyze, and report operational and clinical performance metrics. Use data to identify trends, emerging risks, capacity concerns, and improvement opportunities.
• Change Management: Lead teams through new programs, technology changes, workflow redesigns, and organizational initiatives.
• Escalation Management: Provide leadership and decision support for complex operational patients, providers, and workflow escalations and coordinate appropriate resolutions.
• Quality and Compliance: Ensure assigned operations are performed in accordance with organizational policies, clinical standards, regulatory requirements, privacy requirements and applicable best practices.
• Resource and Capacity Management: Support staffing, scheduling, workload management, and resources planning based on operational demand and program priorities.
• Training and Onboarding: Partner in the development and implementation of onboarding, training, job aids, procedures, and other resources necessary to support consistent and compliant performance.
• Business Continuity: Provide leadership during urgent operational events, system outages, significant workflow disruptions, or other situations requiring coordinated clinical operations response.
• Special Projects: Lead or participate in cross-functional initiatives and special projects based on organizational priorities.

Required Knowledge/Skills/Abilities

• Strong operational and systems-thinking skills, with demonstrated ability to evaluate complex workflows and translate problems into practical solutions.
• Demonstrated experience with process improvement, workflow design, program implementation, and change management.
• Strong people leadership and performance management skills.
• Ability to manage multiple programs, priorities, and stakeholders in a fast-paced environment.
• Strong analytical skills and ability to use operational data and performance metrics to drive decisions.
• Excellent written and verbal skills with the ability to communicate effectively with frontline employees, clinicians, and senior leaders.
• Strong cross-functional collaboration, influencing, and relationship management skills.
• Ability to independently identify problems, investigate root causes, develop recommendations, and drive solutions.
• Understanding of healthcare operations, patient care coordination, clinical workflows, and healthcare regulatory requirements.
• Familiarity with electronic medical records and care management platforms.
• Strong technology skills, including proficiency with Excel.

Education and Experience

PREFERRED:

• Experience supporting BH or psychiatric services, including BH practice operations, care coordination, referrals, social work, nursing, or related services.
• Experience working in telehealth, virtual care, managed care, health plans, medical groups, or other complex healthcare delivery systems.
• Experience leading cross-functional teams.
• Clinical licensure such as RN, LCSW, LMSW, LMHC, LPS, CCM, or comparable credentials.

WILL CONSIDER:

• Bachelor's degree in healthcare administration, nursing, social work, psychology, business, operations, or equivalent relevant healthcare operations experience.
• Demonstrated experience in healthcare operations, clinical operations, behavioral health operations, care coordination, or related healthcare environment.
• Previous leadership experience with responsibility for people, programs, workflows, or operational performance.
• Demonstrated experience improving processes, implementing workflows, or managing healthcare programs.

Physical Demands

While performing the duties of this job, the employee is required to stand, walk, or sit; use a keyboard and computer mouse; reach with hands and arms; balance, stoop, kneel, bend, talk, and hear. The employee must occasionally lift and/or move up to 25 pounds. The physical demands described herein are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Work Environment

Work is performed in a quiet, HIPAA-compliant, at-home office environment.

Travel Requirements

Minimal

Position Location

Remote

Security Roles and Responsibilities

MD Live employees may have access to Protected Health Information and/or Personally Identifiable Information that is subject to privacy regulations by state and federal statutes. All employees must comply with all applicable regulations and all MD Live policies and procedures for the security and privacy of such information.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an annual salary of 94,700 - 157,900 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

At The Cigna Group, you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here.