Clinical Operations Lead - Social Work Case Management

Highmark Health; Nashville (TN); Remote; USD 94,000 - 151,000; Full time

Job summary

Highmark Health in Nashville leads a team of licensed clinical professionals delivering social work case management services to a defined member panel. The role focuses on clinical quality, member outcomes, regulatory compliance, and workforce development, with accountability for business performance and strategic initiatives.

You will manage daily operations, staffing, and scheduling to meet outreach targets and ensure staff are clinically competent.

Qualifications

• Master's Degree in Social Work or related field required.
• MS in Social Work or Social Welfare preferred.
• 5 years of health-related clinical work experience required.
• 3 years of management/supervisory experience preferred.

Responsibilities

• Leads clinical operations and ensures quality of social work services.
• Oversees staffing, scheduling, and day-to-day department operations.
• Ensure adherence to CMS/state/local regulations and internal policies.
• Drive engagement and improve member outcomes and care plans.

Skills

Leadership

Team management

Clinical operations

Regulatory compliance

Strategic planning

Performance metrics

Communication

Virtual leadership

Project management

Quality improvement

Education

Master's Degree in Social Work or related field

MS in Social Work or Social Welfare

Tools

Microsoft Office

Clinical platforms

Workflow technologies

Job description

Highmark Health in Nashville leads a team of licensed clinical professionals delivering social work case management services to a defined member panel. The role focuses on clinical quality, member outcomes, regulatory compliance, and workforce development, with accountability for business performance and strategic initiatives.

You will manage daily operations, staffing, and scheduling to meet outreach targets and ensure staff are clinically competent.