Manager Health Plan Clinical Operations RN
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At a glance
Requirements
Credentials this posting asks for.
Job overview
The Manager of Health Plan Clinical Operations oversees the Clinical Services Team, ensuring departmental and company goals are met. Responsibilities include directing day-to-day clinical operations, maintaining quality standards, managing team performance under utilization and quality programs, and providing oversight to achieve optimal utilization management and quality outcomes while communicating effectively with patients, families, and staff.
Skills & qualifications
Skills
Qualifications
Full job description
Employment Type: Full timeShift:
Description: This position manages the activities of the Health Plan Clinical Services Team to ensure the achievement of department and company goals. The Clinical Manager will be responsible for overseeing the day-to-day clinical operations of the health plan, including patient care, staff management, and maintaining quality standards. Responsibilities include managing the performance of the team in accordance with the Upstream Health Plans Utilization and Quality Programs. Providing oversight and support to ensure overall outcomes and optimal Utilization Management and Quality performance.
- Current licensure as a Registered Nurse in the State of California is required. Clinical professionals currently licensed outside the State of California will be provided six (6) months from date of hire to obtain equivalent California state licensure.
- Bachelor's Degree is required. Three years of Nursing Leadership experience may substitute for the Bachelor's Degree requirement.
- Two (2) years of management experience is required.
- Ability to communicate effectively with patients, families, and health care personnel and ability to lead, direct, and mentor personnel is required.
- Health Plan experience preferred.
Pay Range ($58.99 - $88.50)
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
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