Bachelor's degree in healthcare or related field required; master's degree preferred
Active, unrestricted RN license required
Minimum of 3 years progressive supervisory and/or management experience
5 years of progressive experience in healthcare services, clinical operations, quality, or care management
5 years of experience in closure of care gaps or care coordination preferred
Prior experience building and managing relationships with healthcare providers or patients preferred
Proof of valid and unrestricted driver's license required
Responsibilities
Function as ambassador for the organization with all internal and external customers
Collaborate with team to engage providers and members, serving as escalation point for complex issues
Implement policies, procedures, and action plans to enhance team performance
Ensure communication among multi-disciplinary teams for coordinated customer engagement
Monitor KPIs to identify trends and develop action plans for improvement
Develop and report on team performance and productivity
Promote continuous improvement through audits and education initiatives
Benefits
Hybrid work environment
Opportunities for professional development and continuous education
Supportive team culture focused on employee engagement
Comprehensive compliance with NCQA standards
Commitment to HIPAA privacy and security policies
Full Job Description
Description
Position at Healthmap Solutions
Position SummaryThe Regional Manager Clinical Services will be responsible for planning, directing, and overseeing the performance of a team of assigned Provider and Member facing staff. The position will oversee the administrative, clinical, and quality activities related to building strong provider and member engagement and health outcomes.
In this role, we're looking for candidates that are heavy on the Provider facing side.
Responsibilities
Function as ambassador for organization with all internal and external customers
Collaborate as needed with team to help engage providers and members and serve as escalation point for difficult practices and/or members
Implement organization policies, procedures, workflows, and action plans to drive team performance
Ensure collaboration and communication among multi-disciplinary teams to ensure they are coordinated in working toward maximum customer engagement and improved member outcomes
Monitor Key Performance Indicators (KPIs) to identify trends and areas of opportunity that will guide regional strategy; Develop action plans and/or remediation strategies to address areas of opportunity
Develop, monitor, and report on team performance and productivity
Troubleshoot technical issues as needed
Promote an environment of continuous improvement through on-going team audits, provider practice visits, and monitoring of member calls to identify gaps in teams' skills and competencies; Work to develop ongoing team education to address areas of opportunity
Develop, coach, and mentor team members to achieve company, department, and individual goals
Conduct yearly performance evaluations and provide constructive feedback to redirect team members with a positive discipline approach
Maintain team performance according to National Committee for Quality Assurance (NCQA) standards including but not limited to appropriate provider and member documentation
Comply with HIPAA privacy laws, all other federal and local regulations, and company security policies
Provide recommendations to the leadership regarding necessary operational adjustments needed to ensure organizational objectives and goals are met
Perform other related duties as assigned
Requirements
Bachelor's degree in healthcare or related field required; master's degree preferred
Active, unrestricted RN license required
Minimum of 3 years progressive supervisory and/or management experience required
5 years of progressive experience in healthcare services, clinical operations, quality, or care management required
5 years of experience in closure of care gaps or care coordination preferred
Prior experience building and managing relationships with health care providers or patients preferred
Proof of valid and unrestricted driver's license required
Must be able to successfully comply with the credentialing process
Skills
Excellent verbal, written and presentation skills
People skills to develop and maintain strong 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
Must be proficient in Microsoft Office: Outlook, Word, Excel, PowerPoint
TravelModerate Travel, up to 25%, throughout the state of Florida.
#LI-Hybrid
About Healthmap Solutions
Healthmap Solutions is a healthcare company that provides technology-enabled services to help healthcare organizations improve patient outcomes and reduce costs. They offer a range of services including care management, population health management, and risk adjustment. The company was founded in 2010 and is headquartered in Oxnard, California. They have a team of experienced healthcare professionals who work closely with clients to develop customized solutions that meet their specific needs. Healthmap Solutions has worked with a variety of clients across different sectors of the healthcare industry, including health plans, provider groups, and government agencies.
