RN Regional Manager, Clinical Services

Description

Position at Healthmap Solutions

Company Background

Healthmap Solutions is the future of specialty health management that focuses on progressive diseases, with a particular expertise in kidney health populations. Healthmap Solutions uses clinical big data resources and high-powered analytics to power complex specialty health management programs. Healthmap Solutions is a diverse, growing company committed to our clients and our employees. We are champions for better health, for those who need us most.

Position Summary

The 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.

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

Monitor practice profiles monthly to ensure that practices with newly attributed members are appropriately assigned to a PRT

Troubleshoot technical issues within Compass and / or Tableau 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 required; master’s degree preferred

Active, unrestricted RN license required

Basic Life Support (BLS) certification required

Advanced Cardiovascular Life Support (ACLS) certification (based on role)

Minimum of two 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

Must reside in Regional Territory

Proof of valid and unrestricted driver’s license required

Must comply with organization policies for health screening and immunizations, including but not limited to :

Current Tuberculosis (TB) test or current chest X-ray

Proof of immunizations (e.g., Hepatitis B, MMR, Varicella, COVID-19, Influenza)

Participation in annual health and wellness screenings

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

Travel

Moderate Travel. Monthly travel, primarily in the LA / San Diego, CA, market.

Americans with Disability Specifications

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

As an Equal Opportunity Employer, we will not discriminate against any job candidate or employee due to age, race, religion, ethnicity, national origin, gender, gender identity / expression, sexual orientation, disability, familial status, veteran status, marital status, parental status, or pregnancy. In our innovative and inclusive workplace, we prohibit discrimination and harassment of any kind.