Remote Group Health Operations Leader (RN)

Dane Street; Northern (KY); Hybrid; USD 110,000 - 150,000; Full time

Benefits offered by this job

Comprehensive benefits

401k with company match

Remote work setup stipend

Apple equipment provided

Job summary

Dane Street is seeking an Operations Manager to lead and optimize the Group Health division in a fast-paced healthcare environment. You will direct daily operations, guide a multidisciplinary team, and ensure clinical accuracy and rapid turnaround in utilization reviews.

You will collaborate across QA, Training, HR, and Medical Leadership, ensuring client requirements and regulatory guidelines are met while promoting a culture of continuous improvement and remote collaboration.

Qualifications

• RN license required.
• Healthcare operations leadership experience required.
• Experience managing KPIs across productivity, quality, and turnaround time.
• Experience leading multidisciplinary teams including clinical and non-clinical staff.
• Experience collaborating with medical leadership and QA/Training teams.

Responsibilities

• Lead day‑to‑day operations for the Group Health division, ensuring workflow, staffing, prioritization and timely completion.
• Oversee UR Nurses, QA Specialists, CS Representatives and other operational staff.
• Manage end‑to‑end workflow from referral intake to case completion and client updates.
• Provide clinical and utilization review guidance on workflows and complex cases.
• Escalate to Medical Director for clinical questions and ensure adherence to regulations and SLAs.
• Support new client implementations and capacity planning to meet growth.

Skills

Utilization Review

Healthcare ops leadership

KPI management

Staff management

Clinical guidance

Cross-functional collaboration

Education

RN license

BSN or related field preferred

Job description

Dane Street is seeking an Operations Manager to lead and optimize the Group Health division in a fast-paced healthcare environment. You will direct daily operations, guide a multidisciplinary team, and ensure clinical accuracy and rapid turnaround in utilization reviews.

You will collaborate across QA, Training, HR, and Medical Leadership, ensuring client requirements and regulatory guidelines are met while promoting a culture of continuous improvement and remote collaboration.