Clinical Operations Manager

Alight • Indiana, Indiana • 1d ago

The Clinical Operations Manager will manage the activities of a team of clinical case managers supporting STD, FMLA and LTD. Also, the Clinical Operations manager will provide oversight and asst in training of all clinical protocols and best practices used by our absence management clinical staff, including Registered Nurses, and Vocational Rehabilitation Counselors. The Clinical Operations Manager will serve as a Senior Clinical reviewer for highly complex, high-profile escalated claims.

You will

Manage a team of clinical case managers (CCM's)

Lead, motivate, and develop assigned clinical case manager staff

Assess and monitor clinical case manager's workload capacity and efficiency

Assess and measure staff performance and set appropriate goals

Perform mid-year and annual performance evaluations, communicating expectations, goals, deadlines and team results

Monitor and control personnel issues of clinical claim managers and work directly with Human Resources as needed

Coordinate with other clinical operations managers to provider clinical case management support across Alight's book of business.

Conduct clinical audits and provide feedback and mentoring, coordinate with clinical leaders on corrective actions as applicable

Support operations claims teams by monitoring and resolving escalated customer complaints related to clinical issues

Participate in the reinforcement of return-to-work best practice protocols and workflows

Occasionally assist with overflow of clinical reviews upon request of manager

Perform side by side listening/shadowing and coaching with team members to assist in further development of clinical staff.

Collaborate with senior clinical reviewer for highly complex high profile disability claims and/or escalated claims.

Conduct regular clinical round tables to determine level of functional impairment based on knowledge of medical signs and symptoms and the employer's essential job functions and reinforce methodology of reviewing claims based on best practice case review per Medical disability guidelines review protocol.

You have

RN license

1-3 years minimum of clinical experience

Minimum of 5 years of experience in disability management and/or managed care

2+ years of supervisory experience

Unrestricted state clinical licensure

Superior clinal case manager skills and eagerness to function in a leadership role

Strong teaching or mentorship skills

Advanced problem-solving and analytical skills

Excellent communication (written/verbal) and relationship building skills

Superior ability to work in a team setting

Ability to communicate complex information in a mentoring/training situation

Strong organization skills, time management and follow-through are essential

Strong presentation skills

We offer you a competitive total rewards package, continuing education & training, and tremendous potential with a growing worldwide organization.

DISCLAIMER:

Nothing in this job description restricts management's right to assign or reassign duties and responsibilities of this job to other entities; including but not limited to subsidiaries, partners, or purchasers of Alight business units.

Alight

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