Easter Seals Jobs

Senior Manager Clinical Services Job Locations

US-Remote ID

2024-14042

Category Clinical Operations  

Position Type Full-Time Overview

The Senior Manager of Clinical Services will be responsible for driving operational efficiency, product quality, clinical review optimization and alignment to meet client needs for HEDIS, STAR and other health measure chart review and abstraction related services. This role will closely partner with Program and Product Management teams to prioritize innovation and support our market and customer needs. HEDIS is a registered trademark of NCQA.

Responsibilities

Plan, coordinate and manage daily production for HEDIS abstraction and overreading to ensure meeting SLA's and timelines. Work with on and offshore contractors/vendors and internal staff to meet staffing and production requirements. * Develop, implement and monitor department key performance indicators that ensure quality, completeness, and timeliness of core department responsibilities. * Assist in recruiting and hiring new staff, manage existing staff, and develop and implement training and orientation programs that ensure consistency and accuracy. * Assist in developing departmental budget, managing expenses, and appropriate resource utilization. * Deep understanding of business needs of our clients, including challenges they face and other industry trends occurring. Ability to translate these needs into concrete initiatives with strong business cases supporting decisions * Participate in sales calls/demos to support abstraction offering. * Hire, develop, coach, lead and retain top-tier talent, with a focus on building and improving a team and culture that is able to assist in employing best in class practices to support and drive high levels of internal and external customer satisfaction. * Complete all responsibilities as outlined in the annual performance review and/or goal setting. * Complete all special projects and other duties as assigned. * Must be able to perform duties with or without reasonable accommodation.

This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and requirements of the job change.

Qualifications

• Active unrestricted licensure or certification as an RN, LPN, or other related clinical professional in state of residence, BSN/MSN or other advanced healthcare related degree preferred.
• 1-year clinical experience providing direct patient care w/minimum 5 years HEDIS abstraction experience required.
• 3+ years formal leadership experience.
• 3+ years Project management experience including time-sensitive production-based projects with global distributed teams, contract staff, multiple clients and/or lines of business, preferred.
• Ability to track, trend, and analyze data to identify areas of opportunity for additional action needed at the Abstraction Team Member level.
• Strong proficiency with Microsoft Office
• HEDIS/abstraction systems experience required, experience with Cotiviti Quality Reporter tool preferred.
• Strong organizational, analytical (business level math/basic statistical analysis), and interpersonal skills.
• Excellent written and verbal communication skills with ability to present data at staff, peer, management and client level.
• Detail and process oriented with focus on efficiency and attention to detail critical to accuracy of work product. Mental Requirements:
• Multi-tasking and the ability to prioritize and make indep endent decisions *... For full info follow application link.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities