Clinical Operations Manager- Care Management

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.

Job title:

Clinical Operations Manager- Care Management

Job Description:

Sagility is a global leader specializing in augmenting healthcare teams to better patient, member, business and financial outcomes in partnership with payers and providers. A Leader who can interact closely with members and patients to deliver evidence-based, timely, preventative, personalized, cost-effective care with focus on the whole person that improves health, value and overall quality of life.

We are currently hiring an Clinical Operations Manager- Care Management to join our team!

Skills Required:

• People Management/ Team Orientation

• Drive for Results/ Execution

• Expertise/ Analytical Skills

• Product Knowledge

• Presentation Skills

• Process Improvement

• Change Management

• Organizing and Management Skills

• Communication Skill (Spoken)

• Communication Skill (Written)

• Customer Service Orientation

• Computer Literacy

• Job Knowledge

• Sense of Urgency

• Passion for Excellence

• Working in Teams/ Interpersonal Skills

• Work Organization

• Thriving in Change

• Problem Solving

• Facilitation Skills

• Coaching

• Performance Management

• Discipline Management

• Conflict Management

• Fiscal Management

• Business Acumen

• Planning, Organizing, Controlling

Role Expectation:

• Monitors daily all areas of performance metrics (call handling times, service levels & quality grades) to assure that standards are met across the board referring to a database, a program or reports. 

• Works to administer program and implement both client and in house policy.

• Ensures that operations are being managed accordingly on a day-to-day basis.

• Attends client meeting on a regular basis or as needed to discuss the program performance based on the key operational metrics.

• Interface with client during visits, do presentation regarding performance of the program if need be and escalate issues that are out of the ordinary.

• Attends weekly operations review and present action plans to issues that need to be addressed.

• Collates and responds to operational issues as reported by Team Leads – as needed.

• Escalates operational issues beyond level of authority to the Department Head – as needed.

• Informs the Department Head when the system needed (system error/downtime) to handle calls are not working effectively – as needed.

• Submits weekly and monthly ops review report to the Department Head.

• Minimizes or manages at acceptable level the customers’ complaints

• Works with the Department Head to further develop program and implement policy – as needed.

• Works with the Team Leads and all Support Managers in coordination with other groups in coming up with programs that will help further develop the associates.

• Recommends new or modifications to existing procedures to ensure Continuous Process Improvement (CPI).

• Evaluates management and contact center practices for possible modifications that will result in increased employee efficiency and satisfaction.

• Responsible for the development and implementation of policies and procedures pertaining to HIPAA and ensures the center is in compliance with Privacy Rules Standard.

• Ensures that the Operations Team meets productivity standards – daily.

• Provides daily leadership and motivation to the Operations Team.

• Conducts monthly one-on-one coaching to direct reports and provide feedback to drive performance and reduce cost using data from reports on Attendance, handling time, productivity and quality grades.

• Devises strategic communication plan to ensure all changes are relayed on time and accurately.

• Creates incentives for all staff in conjunction with meeting performance measurements.

• Conducts weekly meetings with direct reports to discuss team and