Registered Nurse Regional Manager - Clinical Services

Description

• 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
• Troubleshoot technical issues 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

• Bachelor's degree in healthcare or related field required; master’s degree preferred
• Active, unrestricted RN license required
• Minimum of 3 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
• Proof of valid and unrestricted driver’s license required
• Must be able to successfully comply with the credentialing process
• Must be located in PST or MST time zone

• 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