Clinical Services Manager / St Petersburg FL – 1805040111
As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!
JOB SUMMARY
Provide coordination and management of Clinical Services Management team to maximize quality of service. This includes monitoring, evaluating and coaching case managers. Responsible for case managers’ productivity in achieving Call Center standards such as service level, work time, calls handled per day and customer service.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Responsible for client implementation, education and training
- Serve as the primary resource for internal and external department interaction relating to new/existing clients during the implementation phase
- Provide on-site client education (end user) including but not limited to case management staff, clinical personnel and facility administrators
- Partner with sales, providing clinical expertise and support to achieve and ensure program growth
- Make client on-site visits to assess work-flow and opportunities for strengthening client partnership. Build and Manage Customer Relationships, including identifying additional service offerings as well as ensuring customer satisfaction and responsiveness
- Leadership and direction of clinical call center staff to include, recruiting, counseling and training
- Call Center process improvement
- The ability to effectively interface with Secondary Review Level, when appropriate
- Internal staff development including on-going education and competency evaluation
- Evaluate facility compliance to clinical policy, procedure and care.
- Responsible for reviewing three-month and annual evaluation of team members and any follow-up or corrective actions needed.
- Assists in the implementation of and monitor compliance with policies, procedures, and standards of practice consistent with corporate and external regulatory guidelines.
- Assist in the development, implementation, and monitoring of an accurate and effective documentations system.
- Must be able to complete InterQual Certified Trainer course.
- Thorough knowledge of level of care criteria and care management protocols.
- Knowledge of current clinical trends, insurance plans, budgeting and contract deliverables.
- Develop, maintain and periodically update written policies and procedures as necessary in collaboration with facility directors.
- Monitor all pertinent websites for change in regulations that affect all clinical aspects of nursing and communicate to Director of Clinical Services. Assist with interpretation of regulatory changes and disseminate information to staff.
- Develop and implement Best Practice Protocols in collaboration with leaders.
- Maintain a reference library of written materials to assist with training new staff as identified through inspections/audits
- Provide hands on Management of shift coverage and case reviews when workload requires intervention.
SUPERVISORY RESPONSIBILITIES
This position carries out supervisory responsibilities in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
KNOWLEDGE, SKILLS, ABILITIES
- Computer proficient, with strong keyboarding skills
- Working knowledge of Microsoft Office, Power Point, Word and Excel required
- Ability to travel regularly and frequently
- Accomplished and dynamic public speaking skills required
- Training/education experience preferred
- Strong clinical knowledge base
- Confident and competent with InterQual Product application
- Self-motivated and able to work efficiently
- Analytics and problem solving skills
- Excellent verbal and written communication skills
- Strong interpersonal relations skills
- Strong organizational, managerial and leadership skills
EDUCATION / EXPERIENCE
- Minimum of three (3) years management in sales and/or process environment experience strongly desired
- Medical industry knowledge a plus
- Bachelor’s degree preferred
PHYSICAL DEMANDS
- Must be able to work in sitting position, use computer and answer telephone.
- Required to use fine motor skills (typing/data entry), and reach with hands and arms.
- Ability to travel
WORK ENVIRONMENT
- Subject to varying and unpredictable situations, many interruptions, multiple calls and inquiries, and change.
- May be required to work long hours and holidays.
- Is required to rotate call and provide weekend coverage
Conifer Health Solutions
Location: FL-Saint Petersburg
Job Type : Full-time
Shift Type : Days
Interested? Please email your resume to [email protected]. We’d love to hear from you!
