About this role
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 staffAssess and monitor clinical case manager's workload capacity and efficiencyAssess and measure staff performance and set appropriate goalsPerform mid-year and annual performance evaluations, communicating expectations, goals, deadlines and team resultsMonitor and control personnel issues of clinical claim managers and work directly with Human Resources as neededCoordinate 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 applicableSupport operations claims teams by monitoring and resolving escalated customer complaints related to clinical issuesParticipate in the reinforcement of return-to-work best practice protocols and workflowsOccasionally assist with overflow of clinical reviews upon request of managerPerform 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 license1-3 years minimum of clinical experienceMinimum of 5 years of experience in disability management and/or managed care2+ years of supervisory experienceUnrestricted state clinical licensureSuperior clinal case manager skills and eagerness to function in a leadership roleStrong teaching or mentorship skillsAdvanced problem-solving and analytical skillsExcellent communication (written/verbal) and relationship building skillsSuperior ability to work in a team settingAbility to communicate complex information in a mentoring/training situationStrong organization skills, time management and follow-through are essentialStrong 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. .