Clinical Operations Manager

6 days ago

Ridgefield, New Jersey, United States VNS Health Full time
About the Role

VNS Health is seeking a highly skilled Clinical Operations Manager to oversee the day-to-day business operations of our clinical and non-clinical support activities. As a key member of our team, you will be responsible for monitoring internal processes, coordinating activities between clinical and non-clinical staff, and supervising support functions to facilitate efficient clinical operations.

Key Responsibilities
  • Operational Oversight: Supervise and coordinate the day-to-day business operations of clinical and non-clinical support activities, ensuring efficient and timely operations.
  • Process Improvement: Make recommendations on operational improvements for the department, ensuring customer satisfaction and efficient operations.
  • Staff Supervision: Supervise the day-to-day operations of VNS Health Plans Medical Management clinical and non-clinical staff, making recommendations for development, utilization, and evaluation of internal processes.
  • Customer Service: Troubleshoot difficult customer service issues, facilitate problem resolution, and direct staff in addressing and resolving day-to-day operational issues.
  • Strategic Planning: Assist the management team in developing long- and short-range objectives for the department, including system and operational rollouts and coordination of non-clinical support functions.
  • Training and Development: Provide input to the Education and Quality department regarding training needs for new initiatives, participating in the overall planning, implementation, and evaluation of such programs.
  • Quality Assurance: Ensure adherence to regulatory and VNS Health Plans standards, ensuring compliant operations and department readiness for internal and external audits.
  • Business Operations: Oversee business operations, workflows, utilization, and schedules, contributing to systems design and implementation, and participating in developing standards to measure, maintain, and maximize efficiencies and meet operational needs.
  • Staff Management: Perform all duties inherent in a supervisory role, ensuring effective staff training, interviewing candidates for employment, evaluating staff performance, and recommending hiring, promotions, salary actions, and terminations as appropriate.
Requirements
  • Licenses and Certifications: License and current registration to practice as a Registered Professional Nurse in New York State or Licensed Social Worker Required
  • Education: Bachelor's Degree in Nursing or other health-related degree for RNs Required, Master's Degree in Social Work for LSW Required
  • Work Experience: Minimum three years progressive customer service or business operations experience, preferably in a healthcare environment. Required, Supervisory experience Preferred
  • Skills: Proficient in Personal Computers applications, including Microsoft Word and Excel Required, Knowledge of medical terminology, pharmacology information, and/or insurance terminology Required, Strong knowledge of operations of manual and automated office systems and procedures Required, Strong knowledge of third-party payer requirements for reimbursement Preferred

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