Vheda Health

The job involves overseeing clinical operations, managing staff, ensuring quality member outreach, and maintaining compliance within a healthcare setting. | Requires 7+ years of healthcare leadership experience, familiarity with clinical operations, managed care, and quality improvement, along with a master's degree in healthcare or related field. | We're Hiring a Health Services Clinical Manager to Join Our Team! We're seeking a talented and motivated Health Services Clinical Manager to join our team. In this role, you will oversee and manage the day-to-day operations of the Health Services department. This role involves ensuring high-quality member care, managing Health Services staff consisting of clinical and non-clinical staff, and implementing policies and procedures to enhance the efficiency and effectiveness of all clinical services. Key Responsibilities Clinical Operations Management: Oversee the daily operations of the clinical department, ensuring smooth and efficient workflows. Develop and implement clinical policies and procedures to maintain high standards of care. Staff Management: Recruit, train, and supervise clinical staff, including nurses, clinical coordinators, and member advocates. Conduct performance evaluations, provide feedback, and facilitate professional development opportunities. Member Outreach Quality: Monitor and evaluate the quality of member outreach conducted by the clinical team. Implement quality improvement initiatives to enhance member outcomes and satisfaction. Compliance and Member Engagement: Ensure compliance with all relevant healthcare regulations, standards, and best practices. Perform routine quality chart and call audits to improve member outcomes and drive organizational success. Collaboration and Communication: Foster effective communication and collaboration among clinical staff, and other departments (Member Experience Team, Shipping, Analytics and Leadership) Serve as a liaison between the clinical team and other stakeholders, including members and their care team, and external partners/supports (Client Partners). Technical Support Oversight: Oversee clinical team collaboration with technical support to ensure timely resolution of member or system issues. Required Qualifications Education: Master's degree in healthcare administration, public health, or related field. Experience: 7+ years of leadership in healthcare services, particularly clinical operations, managed care, or population health. Knowledge: Familiarity with chronic conditions, NCQA, HEDIS, case management, and utilization management. Preferred Qualifications · Proficiency in telephonic and remote work environments. · Strong care coordination capabilities. · Care/Case Management Experience or certifications. · Experience in Urgent or Emergent care settings. · Leadership and team management skills. · Expertise in quality improvement and patient/member care. · Knowledge of regulatory compliance. · Effective resource management. · Excellent communication and collaboration abilities. · Oversight of technical support operations. Why Join Vheda Health? At Vheda Health, we invest in our team's wellbeing with a comprehensive benefits package: · Compensation: Competitive salary within the published range plus performance bonus and equity opportunities · Healthcare: Comprehensive medical, dental, and vision coverage · Financial Security: 401(k) retirement plan, voluntary life insurance, short and long-term disability · Work-Life Balance: Unlimited paid time off and 12 paid company holidays · Community: Engaging team events and activities throughout the year Base salary range: $68,000–$85,000 per year