Clinical Quality Call Center Nurse Manager - Remote

Freddie Mac; Eden Prairie (MN); Remote; USD 177,000; Full time

Job summary

A leading healthcare services company is seeking a Manager to supervise a team and ensure compliance with regulatory initiatives. This remote position offers a competitive salary and comprehensive benefits, along with opportunities for career advancement and a supportive work environment. Ideal candidates will have extensive healthcare knowledge and managerial experience.

Benefits

Comprehensive benefits package

Equity stock purchase

401k contribution

Opportunity for career advancement

Supportive work environment

Qualifications

• 5+ years of managerial experience in a healthcare setting.
• Extensive knowledge of Medicare Part D and pharmacy record review.
• Demonstrated writing skills with attention to detail.

Responsibilities

• Supervise and coordinate a team of supervisory leaders.
• Handle escalated calls and assist members with inquiries.
• Monitor metrics to ensure target goals for STAR performance.

Skills

Managerial experience

Knowledge of Medicare Part D

HIPAA Privacy and Security Rules

General writing skills

Bilingual abilities

Education

Undergraduate degree or equivalent experience

Master’s degree or equivalent experience

Job description

Employer Industry: Healthcare Services

Why consider this job opportunity:
- Salary up to $176,700 annually
- Comprehensive benefits package including equity stock purchase and 401k contribution
- Opportunity for career advancement and growth within the organization
- Work remotely from anywhere within the U.S.
- Supportive and collaborative work environment
- Chance to make a positive impact on health outcomes and community well-being

What to Expect (Job Responsibilities):
- Supervise and coordinate a team of supervisory leaders, ensuring compliance with regulatory initiatives and performance targets
- Handle escalated calls from members and assist them with inquiries
- Conduct performance reviews and support leadership with presentation development
- Monitor metrics to ensure target goals are met for STAR performance
- Participate in clinical quality improvement initiatives and perform other related duties as assigned

What is Required (Qualifications):
- Undergraduate degree or equivalent experience
- 5+ years of managerial experience, preferably in a healthcare setting
- Extensive knowledge of Medicare Part D, including pharmacy record review and reimbursement rules
- Working knowledge of HIPAA Privacy and Security Rules and CMS security requirements
- Demonstrated general writing skills with attention to detail

How to Stand Out (Preferred Qualifications):
- Master’s degree or equivalent experience
- Experience in Pharmacy Benefit Management (PBM)
- Call center management experience
- Bilingual abilities

#HealthcareServices #ManagementOpportunity #RemoteWork #CareerGrowth #ClinicalQuality

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