Clinical Operations Lead - Social Work Case Management

Highmark Health; Northern (KY); Remote; USD 94,000 - 151,000; Full time

Job summary

Highmark Health in the United States seeks a Clinical Operations Leader to guide a licensed social work team delivering case management to a defined member panel with varied health needs.

The role ensures clinical quality, regulatory compliance, and performance against engagement, care plans, and cost targets, while scaling remote workforce capabilities and cross-functional collaboration across health plan operations and provider relations.

Qualifications

• Master's degree in Social Work or related field is required.
• MS in Social Work is preferred.
• Experience leading social work, care management, or related operations is desirable.

Responsibilities

• Lead a team of licensed clinical professionals delivering social work case management.
• Manage staffing, scheduling, and performance against quality and cost targets.
• Ensure adherence to evidence-based social work practices and organizational policies.

Skills

Clinical leadership

Team management

Virtual leadership

Healthcare operations

Stakeholder collaboration

Communication

Project management

Data literacy

Education

Master's degree in Social Work

MS in Social Work (preferred)

Tools

Microsoft Office

EHR systems

Reporting tools

Job description

Highmark Health in the United States seeks a Clinical Operations Leader to guide a licensed social work team delivering case management to a defined member panel with varied health needs.

The role ensures clinical quality, regulatory compliance, and performance against engagement, care plans, and cost targets, while scaling remote workforce capabilities and cross-functional collaboration across health plan operations and provider relations.