Clinical Operations Lead – RN, US Day Shift, HIPAA Expert

Gratitude Philippines

Quezon

On-site

PHP 1,200,000 - 2,000,000

Full time

4 days ago

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Job summary

Gratitude Philippines in the Philippines seeks an experienced Clinical Operations Assistant Manager to lead a high-performing clinical operations team supporting a major US managed care program. The role drives service excellence, clinical quality, operational performance and team development in a fast-paced, metrics-driven healthcare environment with on-site US day shift.

BSN and active USRN/PHRN licenses are required, along with 5+ years of clinical ops and 3+ years of leadership in healthcare

Qualifications

BSN graduate with active PHRN license and USRN license (NCLEX)
Minimum 5 years of clinical/healthcare ops experience
Minimum 3 years of team leadership in healthcare BPO/shared services
Strong knowledge of US Managed Care, UM, CM, CMS, and HIPAA
Experience managing SLAs, KPIs and clinical ops performance
UR/UM experience with UR operations
URAC/NCQA familiarity is an advantage
Clinical training experience is preferred
Willingness to work onsite on US day shift

Responsibilities

Manage daily SLA/KPI performance (turnaround time, quality, productivity, documentation)
Lead team huddles, interval monitoring, RCA, and performance recovery planning
Ensure HIPAA/PHI compliance across operations
Lead clinical quality assurance audits, calibrations, coaching, and documentation reviews
Develop and mentor RNs, Clinical Associates, and Team Leaders
Oversee competency, preceptorship, CE tracking, and license validity
Collaborate with WFM, TA, QA, and client stakeholders
Translate clinical protocols into practical workflows and training materials