Clinical Workforce Manager

Location: Remote (For Non-Local) or Hybrid (Local to NYC area)

About the Role:

We are seeking for a Clinical Workforce Manager to develop a workforce management program for our Prior Authorization and Clinical Call Center teams. You’ll be responsible for creating and managing workforce strategies that align with our operational goals, ensuring we have the right people in place at the right time, and managing our strategic partnerships. Key responsibilities will include planning, scheduling, forecasting, and budgeting to optimize staffing to ensure exceptional service As part of this role, you'll manage real-time workforce efforts, drive staffing optimization, and provide insights that help shape operational decisions. For this evolving and dynamic role, we’re looking for someone who is creative in their approach to problem-solving, innovative, adaptable, and ready to shape a brand-new function and grow with us.

Position Responsibilities:

• Collaborate with Prior Authorization and Clinical Care Management to develop actionable strategies to optimize staffing levels, drive exceptional customer service and ensure operational efficiency within the department.

• Oversee the daily, real-time performance of agents handling prior authorization requests and clinical calls, ensuring efficient queue management and optimal resource allocation to meet demand and regulatory requirements.

• Manage attendance reporting for agents on a daily, weekly, and monthly basis, ensuring accurate time tracking and shift adherence.

• Address scheduling adjustments, overtime, and undertime requests in a timely manner.

• Ensure agents are assigned to appropriate skill sets, utilizing reports to track performance and adjust assignments as needed.

• Ensure the accuracy of workforce management and payroll data including the creation and maintenance of performance reports reflecting key metrics such as service levels, call volume, agent productivity, and adherence to staffing schedules.

• Leverage data analytics to monitor workforce performance, identify trends, provide insights on staffing requirements, advising on hiring needs and workforce decisions based on forecasts, historical data, and real-time performance metrics.

• Act as the primary point of contact for system-related issues impacting production, collaborating with IT and other relevant teams to resolve any challenges.

• Partner with training departments to schedule training sessions for agents, ensuring minimal disruption to service levels while maintaining appropriate coverage during training hours.

• Prepare and deliver reports on workforce metrics, performance, and strategic initiatives to leadership.

• Research industry standards and benchmark against other call centers and prior authorization departments to stay informed on best practices in service levels, technology usage, and call routing processes.

• Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.?

Skills and Competencies:

• Proven ability to create and execute strategic workforce plans that align with business goals and adapt to changing needs.

• Skilled in forecasting staffing needs and using workforce data to make impactful, data-driven decisions, including data analytic skills

• Experience with workforce management tools and analytics to enhance performance and operational outcomes.

• Strong leadership and mentoring skills to develop and manage a high-performing team.

• Exceptional communication skills to present complex strategies in a clear, accessible way to all stakeholders.

• Creative problem-solving and critical thinking to tackle workforce challenges with innovative solutions.

• Ability to make informed decisions under pressure, adapting strategies as needed in a fast-paced environment.

• Strong project management skills, successfully balancing multiple priorities and driving initiatives from start to finish.

Experience and Qualifications:

• 3+ years of experience in a workforce management role.

• Prior authorization experience at a PBM strongly preferred.

• A bachelor’s degree in business management, math, statistics, economics, or a related field is preferred but not required; equivalent training and experience may be substituted and considered.

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