Clinical Operations Lead - Social Work Case Management

Highmark Health; Dover (DE); Remote; USD 94,000 - 151,000; Full time

Job summary

Highmark Inc. seeks an experienced senior leader to guide a team of licensed clinical professionals delivering social work case management. You will drive clinical quality, member outcomes, and regulatory compliance across a dispersed workforce.

The role emphasizes workforce development, performance management, and strategic collaboration to meet engagement and cost targets while adhering to CMS and regulatory standards.

Qualifications

• Master's Degree in social work, public health, or related field.
• Minimum 5 years of health-related clinical work experience.
• Minimum 3 years in management/supervisory roles.
• Licensure as LSW/LCSW/LPC/LMFT or RN with multi-state licensure (eNLC) preferred.

Responsibilities

• Lead and manage department operations and staffing.
• Provide clinical leadership and ensure evidence-based practices.
• Monitor metrics and drive continuous improvement.
• Collaborate with cross-functional teams to achieve targets.
• Support workforce development and staff coaching.

Skills

Presentation skills

Clinical platforms

AI adoption

Automation opportunities

Cost drivers

MS Office

Remote leadership

Employee engagement

Stakeholder collaboration

Project management

Change management

Enterprise initiatives

Education

Master's Degree - Social Work or related field

MS in Social Work or Social Welfare

Job description

Highmark Inc. seeks an experienced senior leader to guide a team of licensed clinical professionals delivering social work case management. You will drive clinical quality, member outcomes, and regulatory compliance across a dispersed workforce.

The role emphasizes workforce development, performance management, and strategic collaboration to meet engagement and cost targets while adhering to CMS and regulatory standards.