Position OverviewThe RN Clinical Decision Support Team Lead is the first line supervisor and leader of a team of clinical and non-clinical staff supporting a regional payer utilization management program, for the plan's member cohort. This role requires exceptional executive presence, the ability to lead large teams through ambiguity while driving operational excellence. This key support function will have the opportunity to help shape the future of Shearwater's Domestic solution offerings.
In the RN Clinical Decision Support Team Lead role, you will be responsible for:- The oversight, supervision and delegation of work to a team of individual contributors which may include licensed clinical staff and unlicensed administrative support staff.
- Monitoring and coaching of staff according to accreditation and regulatory guidelines and requirements
- Hiring, onboarding, and training to support organizational growth
- Collaboration within a matrixed environment to support operational health.
- Preparation of weekly, monthly, quarterly and yearly reports for both internal and external stakeholders
- Client-facing activities, which include participation in regular meetings and touch points to report project status, evaluate opportunities, and drive excellence in overall operations.
Qualification Requirements:- A Bachelor's Degree, preferably in Nursing or other healthcare related field
- Current active, unrestricted RN license in any state with the ability to obtain the State of Michigan Nursing License (exclusions: Northern Mariana Island, Guam, Puerto Rico).
- At least 4 years' experience leading utilization management programs for Medicare Advantage and Commercial business within a payer environment.
- Proven experience with delivering care management programs to the Medicare and commercial population.
- Strong organizational, planning, analytical, and communication skills.
- Proven ability to lead teams of clinicians and non-clinicians.
- Excellent interpersonal skills.
- Working knowledge of PC applications including Microsoft Office Suite.
- Adaptability and resilience to navigate through change.
- CCM or other case management credentials highly desired.
- Ability to travel at least 10% as needed for client or corporate meetings/events.
- Able to work from home in a distraction free, private office space.
Employee Benefits:- A competitive compensation structure
- Comprehensive health insurance
- 401(k)
- Paid vacation time
- The opportunity to build your career in a rewarding and unforgettable way
