Manager Health Plan Clinical Operations RN

Trinity-Health

$122K — $184K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Current licensure as a Registered Nurse in California required, with a grace period for out-of-state candidates.
  • Bachelor's Degree required or three years of relevant Nursing Leadership experience.
  • Minimum of two years of management experience required.
  • Effective communication skills with patients, families, and healthcare personnel essential.
  • Health Plan experience preferred.

Responsibilities

  • Manage activities of Health Plan Clinical Services Team.
  • Oversee day-to-day clinical operations including patient care and staff management.
  • Maintain quality standards in line with company goals.
  • Manage team performance according to Utilization and Quality Programs.
  • Provide oversight to ensure optimal Utilization Management and Quality performance.

Benefits

  • Full-time employment with stable hours.
  • Opportunities for professional development and training.
  • Supportive team environment with a focus on quality care.
Full Job Description
Employment Type:
Full timeShift:

Description:

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.

1. 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.
2. Bachelor's Degree is required. Three years of Nursing Leadership experience may substitute for the Bachelor's Degree requirement.
3. Two (2) years of management experience is required.
4. Ability to communicate effectively with patients, families, and health care personnel and ability to lead, direct, and mentor personnel is required.

5. Health Plan experience preferred.

Pay Range ($58.99 - $88.50)

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