Manager Health Plan Clinical Operations RN

Trinity Health; Fresno (CA); On-site; USD 80,000 - 121,000; Full time

Job summary

Trinity Health in Fresno, CA seeks a Clinical Manager to lead the Health Plan Clinical Services Team and drive department goals. You will oversee daily clinical operations, patient care, staff management, and ensure quality standards across utilization and quality programs.

Requirements include California RN licensure, a Bachelor’s degree (or substitution with 3 years of leadership experience), and 2 years of management experience, with strong communication and mentoring skills.

Qualifications

• Current licensure as a Registered Nurse in California.
• Bachelor's Degree is required; three years of Nursing Leadership experience may substitute.
• Two years of management experience is required.
• Ability to communicate effectively with patients, families, and health care personnel and ability to lead, direct, and mentor personnel is required.
• Health Plan experience preferred.

Responsibilities

• Manage the activities of the Health Plan Clinical Services Team to achieve department and company goals.
• Oversee day-to-day clinical operations of the health plan, including patient care and staff management.
• Ensure overall outcomes and optimal Utilization Management and Quality performance by the team.

Skills

Nursing leadership

Communication

Staff management

Education

Bachelor's degree

Job description

Employment Type: Full time Shift: Description:

This position manages the activities of the Health Plan Clinical Services Team to ensure the achievement of department and company goals. The Clinical Manager will be responsible for overseeing the day-to-day clinical operations of the health plan, including patient care, staff management, and maintaining quality standards. Responsibilities include managing the performance of the team in accordance with the Upstream Health Plans Utilization and Quality Programs. Providing oversight and support to ensure overall outcomes and optimal Utilization Management and Quality performance.

• 1. Current licensure as a Registered Nurse in the State of California is required. Clinical professionals currently licensed outside the State of California will be provided six (6) months from date of hire to obtain equivalent California state licensure.
• 2. Bachelor's Degree is required. Three years of Nursing Leadership experience may substitute for the Bachelor's Degree requirement.
• 3. Two (2) years of management experience is required.
• 4. Ability to communicate effectively with patients, families, and health care personnel and ability to lead, direct, and mentor personnel is required.
• 5. Health Plan experience preferred.

Pay Range ($58.99 - $88.50)

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.