Manager, Clinical Resource Management Operations

• Collaborates with Clinical Resource Management staff to develop operational models and approaches that optimize Case Management performance and ensure resources are properly allocated to meet organizational goals.
• Translates departmental strategic objectives into operational plans and key messaging. Ensures staff understanding of these plans and implements methods to track their effectiveness.
• Builds strong working relationships with physicians and other organizational partners. Ensures the team understands strategic objectives and that case management services meet stakeholder needs.
• Leads, coaches, and supports case management team members to promote professional growth and effective performance.
• Partners with clinical team members to ensure compliance with screenings for social determinants of health, CSSRS, and completion of MOON and IM forms.
• Designs and implements workflow improvements within the case management system and assists with system training. Includes denials management, payer communication, and performance improvement reporting.
• Develops reports, or collaborates with the Executive Director, to monitor and audit Case Management operations for compliance and data accuracy.
• Works closely with denials staff to provide performance feedback, education, and remediation support when needed.
• Collaborates with the Executive Director to develop and produce high-level reports that support data collection and analysis of team performance.
• Oversees staffing and scheduling functions and validates entries in the ADT payroll system.
• Partners with the Epic team to optimize workflow efficiency and data collection processes.
• Works with case management team leaders to oversee daily operations, address staffing or other operational issues as they arise, and escalate key concerns to clinical managers when appropriate.
• Develops operational plans and prepares reports related to organizational strategic priorities and/or payer requirements as requested.
• Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers.
• Challenges current working practices: identifies process improvement opportunities and presents recommendations and solutions to management. Engages and commits to the organization's culture of continuous improvement by actively participating, supporting, and promoting CCHC Pillars of Excellence.
• Must read, write, and communicate in English
• Bachelor's degree (or higher) in Healthcare or a related field, or an equivalent combination of education and experience
• 3-5 years of experience in healthcare informatics and clinical processes, with strong knowledge of hospital operations
• Demonstrated leadership and coaching skills with the ability to influence and support colleagues
• Proficiency in data analysis and reporting, including experience with Microsoft Office Suite and Epic Reporting tools
• Strong communication skills, including the ability to create effective PowerPoint presentations and present to diverse audiences such as senior management, physicians, and other clinical providers
• Excellent organizational and prioritization abilities, with a clear understanding of stakeholder needs
• Exceptional interpersonal and negotiation skills, demonstrated through a positive, professional, and collaborative demeanor with patients, physicians, staff, and external partners
• Ability to function independently while maintaining high performance standards and contributing effectively in a team-based environment
• Maintains confidentiality in accordance with organizational policies and

Purpose of Position
The Manager of Operations is responsible for leading a team that manages inpatient and observation populations at CCH and FH. This role serves as the primary operational liaison between the Cape Cod Healthcare Case Management team and the multidisciplinary teams at both hospitals. The Manager also collaborates with external vendors to implement strategic initiatives aimed at delivering coordinated, cost-effective, and equitable care. The Manager shares responsibility for overseeing case managers, navigators, social workers, and other Case Management staff. They are expected to collaborate effectively with the team, monitor performance, ensure comprehensive training and onboarding, and participate in annual evaluations. Additionally, the Manager utilizes analytical data to assess productivity and outcomes, supporting the achievement of strategic goals within established budget parameters.

Schedule Details
Full-Time, Monday-Friday, Occasional Evenings, Weekends, & Holidays

Organization
Cape Cod Healthcare, Inc.

Primary Location
Massachusetts-Hyannis

Department
HCI-Care Management

Annual/Hourly
Annual - Based on Full Time Employment

Hiring Pay Range
85000