Clinical Ops Lead — Social Work Case Management

Highmark Health; Boise (ID); Remote; USD 94,000 - 151,000; Full time

Job summary

Highmark Inc. seeks an experienced social work leader to manage a team of licensed professionals delivering case management services. You will ensure clinical quality, regulatory compliance, and workforce development while guiding operational initiatives and program outcomes.

You will lead staffing, supervision, and collaboration with clinical and operational partners to meet engagement targets and clinical metrics, including cost of care, in a dynamic enterprise setting.

Qualifications

• Master's Degree - Social Work or related field (e.g., counseling, public health).
• Preferred: MS in Social Work or Social Welfare.
• Substitutions: None.
• 5 years of health-related clinical work experience.
• 3 years' management or project leadership experience.

Responsibilities

• Oversee daily operations of the department and staffing.
• Hire/terminate decisions, coaching, performance management.
• Develop tactical plans and drive performance to targets.
• Provide clinical leadership and ensure evidence-based social work practices.
• Ensure quality of assessments, care plans, documentation.
• Escalation point for complex psychosocial cases.
• Maintain staffing competency in motivational interviewing and engagement.
• Monitor metrics and drive continual improvement.
• Collaborate across departments to enhance member experience.
• Identify cost savings opportunities within the department.
• Support audits and respond to findings.

Skills

Leadership

Virtual leadership

Communication

Project management

Automation opportunities

Stakeholder engagement

Microsoft Office

Change management

Collaboration

Team development

Education

MSW or related field

MSW / Master’s in Social Work

Tools

Microsoft Office

Job description

Highmark Inc. seeks an experienced social work leader to manage a team of licensed professionals delivering case management services. You will ensure clinical quality, regulatory compliance, and workforce development while guiding operational initiatives and program outcomes.

You will lead staffing, supervision, and collaboration with clinical and operational partners to meet engagement targets and clinical metrics, including cost of care, in a dynamic enterprise setting.