Manager, Clinical Care - Remote

Guidehealth; Chicago (IL); Remote; USD 80,000 - 110,000; Full time

Job summary

A leading company, Guidehealth, is seeking a Manager of Clinical Care in Chicago to oversee daily clinical operations and improve care outcomes. This mid-senior level position involves leading a multi-disciplinary team, ensuring efficient care coordination, and meeting population health needs while achieving strategic goals.

Qualifications

• Experience in case management and care coordination.
• Strong leadership and project management skills.
• Knowledge of quality measures and compliance standards.

Responsibilities

• Manage daily clinical programs to improve efficiencies.
• Oversee an extended patient care team.
• Execute case management for high-risk patients.

Skills

Leadership

Management

Interpersonal skills

Data analysis

Education

Relevant healthcare degree

Tools

EMR systems

Job description

Job Description

The Manager, Clinical Care is primarily responsible for the day-to-day operations of an integrated multi-disciplinary clinical and support structure that monitors, supports, and leads Value-Based clinical initiatives. Responsibilities include case management, transitions of care, care coordination, provider/staff education on ACO/MA Plan clinical programs, and building/maintaining a network of community support. The individual must demonstrate strong leadership, management, and interpersonal skills, utilizing internal and external resources to meet organizational goals.

What You’ll Be Doing

1. Manage daily Health Plan Clinical Programs to improve clinical efficiencies.
2. Identify opportunities to increase outpatient utilization over inpatient care.
3. Use data to manage population health needs and implement population programs for beneficiaries.
4. Execute case management for high-risk patients to reduce emergency visits and hospitalizations.
5. Oversee an extended patient care team, including social workers, emergency department liaisons, behavioral health liaisons, and home health liaisons.
6. Ensure smooth transitional care management for discharged patients, coordinating primary care, DME, home health, specialist appointments, and social services.
7. Review and address quality measures as applicable.
8. Implement health education activities for beneficiaries, providers, and staff.
9. Participate in care coordination, quality committees, and provider meetings.
10. Monitor and achieve utilization and financial goals aligned with corporate strategies.
11. Integrate ACO programs into current operations to meet stakeholder goals.
12. Maintain collaborative relationships within the organization and community.
13. Manage departmental staffing, training, auditing, and performance improvements.
14. Prioritize tasks, manage projects, and ensure departmental efficiency.
15. Ensure compliance with health plan audits and develop action plans as needed.
16. Oversee projects, productivity, and daily activities efficiently.
17. Ensure staff access to EMR systems and compliance with HIPAA regulations.
18. Communicate with health plan contacts and clients to resolve concerns.
19. Disseminate relevant health plan announcements to the team.

Additional Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Health Care Provider
• Industries: Business Consulting and Services, Hospitals and Health Care, Consumer Services

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