Manager, Clinical Performance

Premier Medical; Florida; Sur place; USD 90 000 - 115 000; Plein temps

Résumé du poste

NeueHealth is seeking a Manager, Clinical Performance to lead the clinical staff supporting our clinical programs across the care continuum. You will provide day‑to‑day supervision of UM staff, ensure consistent application of UM criteria, and monitor documentation for adequacy while aligning teams with the NeueHealth Model of Care.

Responsibilities include performance-monitoring, support for care-team meetings, and helping develop performance-improvement plans.

Qualifications

• Bachelor’s degree in nursing, Business, or other related Healthcare field preferred.
• Minimum 1 year experience in a supervisory capacity.
• Minimum 5 years’ experience in medical management (Case Management, Utilization Management)

Responsabilités

• Able to perform the functions of the clinical teams to which the supervisor has direct reporting responsibility, based on scope of practice.
• Responsible for the performance and outcome monitoring data at defined intervals that accurately reflects clinical program activities, key performance indicators and workplans where applicable.
• Responsible for supporting clinical director in the development of performance improvement plans based on deficiencies in key performance indicators
• Responsible for supporting onboarding training and continued education for clinical staff and care partners
• Responsible for ensuring the model of care is consistently applied throughout clinical services.
• Able to complete value stream mapping and desktop procedures to ensure program standardization
• Responsible for supporting clinical directors in conducting care team meetings for care partners.
• Adheres to the Policies and Procedures set forth by the Quality Management Committee and performs all additional duties as assigned

Connaissances

supervisory experience

medical management

onboarding training

Formation

Bachelor’s degree in nursing, Business, or related Healthcare field

Description du poste

NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, we help to make healthcare accessible and affordable to all populations across the ACA Marketplace, Medicare, and Medicaid.

NeueHealth delivers clinical care to health consumers through our owned clinics – Centrum Health and Premier Medical – as well as unique partnerships with affiliated providers across the country. We also enable providers to succeed in performance-based arrangements through a suite of technology and services scaled centrally and deployed locally. Through our value-driven, consumer-centric approach, we are committed to transforming healthcare and creating a better care experience for all.

JOB SUMMARY

The Manager, Clinical Performance is responsible for the direct management of the clinical staff supporting Neuehealth’s clinical programs. programs. The Manager provides day‑to‑today supervision of assigned UM staff. The Manager monitors consistent application of UM Criteria by staff, for each level and type of UM decision. The Manager monitors documentation for adequacy. The Manager will have responsibility for ensuring clinical teams are aligned with the NeueHealth Model of Care.

DUTIES & RESPONSIBILITIES

The Manager, Clinical Performance job description is intended to point out major responsibilities within the role, but it is not limited to these items.

Able to perform the functions of the clinical teams to which the supervisor has direct reporting responsibility, based on scope of practice.

Responsible for the performance and outcome monitoring data at defined intervals that accurately reflects clinical program activities, key performance indicators and workplans where applicable.

Responsible for supporting clinical director in the development of performance improvement plans based on deficiencies in key performance indicators

Responsible for supporting onboarding training and continued education for clinical staff and care partners

Responsible for ensuring the model of care is consistently applied throughout clinical services.

Able to complete value stream mapping and desktop procedures to ensure program standardization

Responsible for supporting clinical directors in conducting care team meetings for care partners.

Adheres to the Policies and Procedures set forth by the Quality Management Committee and performs all additional duties as assigned

EDUCATION AND PROFESSIONAL EXPERIENCE

(Licensures AND Certifications)

Bachelor’s degree in nursing, Business, or other related Healthcare field preferred

Minimum 1 year experience in a supervisory capacity

Minimum 5 years’ experience in medical management (Case Management, Utilization Management)

Training experience preferred

PROFESSIONAL COMPETENCIES

(List professional knowledge, attitude, and skills required in order to work in the job)

Active and unrestricted license as a Registered Nurse (RN) or Licensed Vocational Nurse (LVN)

High Attention to detail and Strong analytical skills

High level of critical thinking and problem‑solving skills

Strong work ethic and overall positive attitude

Effective communication skills including verbal and written

Ability to manage time effectively, understand directions, and work independently in a fast‑paced environment

Demonstrated flexibility, organization, and self‑motivation

Highly adaptable to change

As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of NeueHealth, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.