Registered Nurse - Manager, Clinical Operations (ALBUQUERQUE/TULSA)

Health Care Service Corporation; Albuquerque (NM); On-site; USD 60,000 - 95,000; Full time

Job summary

An established industry player in health care is seeking a dedicated Clinical Supervisor to lead a team of clinical staff in Albuquerque. This pivotal role involves supervising clinical operations, ensuring compliance with account contracts, and fostering a collaborative environment. The ideal candidate will bring a wealth of experience in managed care, strong analytical abilities, and a passion for delivering exceptional service. If you are ready to make a significant impact in a dynamic setting and contribute to the success of a vital organization, this opportunity is perfect for you.

Benefits

Annual Incentive Bonus Plan

Qualifications

• 4 years of clinical managed care experience as an RN.
• 2 years of supervisory experience in a managed care setting.

Responsibilities

• Supervise clinical staff and oversee various clinical operations.
• Implement processes and ensure effective customer service delivery.

Skills

Management Experience

Utilization Management (UM)

Analytical Skills

Interpersonal Skills

Problem-Solving Skills

Presentation Skills

Education

Registered Nurse (RN) License

Bachelor's or Advanced Degree

Tools

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Database Management

Job description

This position is responsible for supervising clinical staff involved in various clinical operations such as risk management and clinical appeals. The role includes hiring, training, performance reviews, pay administration, change management, and ensuring staff meet or exceed goals and initiatives. The supervisor will implement processes, procedures, and initiatives, monitor results, ensure delivery of effective customer service, and ensure the department meets account contracts. Collaboration across the organization is essential to deliver services to the customer.

Position Details

• This is a flex position based in Albuquerque, NM, or Tulsa, OK. It is not a telecommuter/remote position.
• Management experience with direct reports is required.
• Utilization Management (UM) experience is required.
• Willingness to work some weekends and holidays is necessary.
• Work hours are 8 AM to 5 PM MST/CDT.

Job Requirements

• Registered Nurse (RN) with current license in good standing in New Mexico or Oklahoma and 4 years of clinical managed care experience.
• At least 2 years of supervisory experience with direct reports in a managed care setting.
• At least 2 years of clinical experience providing direct care, such as in medical-surgical nursing or home health care.
• Knowledge of nursing practices.
• Strong analytical skills.
• Experience in developing and maintaining self-directed work teams.
• Proficiency in Microsoft Word, Excel, PowerPoint, and databases.
• Ability to develop recommendations for executive management or clients.
• Excellent interpersonal and problem-solving skills.
• Effective presentation skills for internal and external audiences.
• Knowledge of UM metrics, HEDIS, NCQA, and URAC standards.

Preferred Qualifications

• Clinical certification from an approved URAC listing.
• Bachelor's or advanced degree.

The compensation and salary for this position will vary based on skills, education, knowledge, and experience. The role includes participation in an annual incentive bonus plan.

Note: Relocation assistance and sponsorship will not be provided for this position.

We encourage applications from individuals of all backgrounds and experiences.