Health Services Clinical Manager at Vheda Health – Columbia, Maryland

Important Notice: Please be aware of recruiting scams — Vheda Health will never ask for sensitive, personal information or payment information during the hiring process. Further, Vheda Health will only contact eligible candidates (who apply for an eligible role) from our domain — vheda.com. All active career postings can be found at www.vheda.com/careers.

About Vheda Health

Vheda Health is a leader in virtual health engagement, dedicated to improving health equity for underserved populations. With over 10 years of experience and a strong national presence, our turnkey chronic care programs provide simple access to care from anywhere, helping health plans deliver better outcomes for their members.

We're Hiring a Health Services Clinical Manager to Join Our Team!

• We're seeking a talented and motivated Health Services Clinical Manager to join our team. In this role, you will oversee and manage the day-to-day operations of the Health Services department. This role involves ensuring high-quality member care, managing Health Services staff consisting of clinical and non-clinical staff, and implementing policies and procedures to enhance the efficiency and effectiveness of all clinical services.

Key Responsibilities

Clinical Operations Management:

• Oversee the daily operations of the clinical department, ensuring smooth and efficient workflows.
• Develop and implement clinical policies and procedures to maintain high standards of care.

Staff Management:

• Recruit, train, and supervise clinical staff, including nurses, clinical coordinators, and member advocates.
• Conduct performance evaluations, provide feedback, and facilitate professional development opportunities.

Member Outreach Quality:

• Monitor and evaluate the quality of member outreach conducted by the clinical team.
• Implement quality improvement initiatives to enhance member outcomes and satisfaction.

Compliance and Member Engagement:

• Ensure compliance with all relevant healthcare regulations, standards, and best practices.
• Perform routine quality chart and call audits to improve member outcomes and drive organizational success.

Collaboration and Communication:

• Foster effective communication and collaboration among clinical staff, and other departments (Member Experience Team, Shipping, Analytics and Leadership)
• Serve as a liaison between the clinical team and other stakeholders, including members and their care team, and external partners/supports (Client Partners).

Technical Support Oversight:

• Oversee clinical team collaboration with technical support to ensure timely resolution of member or system issues.

Required Qualifications

• Education: Master's degree in healthcare administration, public health, or related field.
• Experience: 7+ years of leadership in healthcare services, particularly clinical operations, managed care, or population health.
• Knowledge: Familiarity with chronic conditions, NCQA, HEDIS, case management, and utilization management.

Preferred Qualifications

· Proficiency in telephonic and remote work environments.

· Strong care coordination capabilities.

· Care/Case Management Experience or certifications.

· Experience in Urgent or Emergent care settings.

· Leadership and team management skills.

· Expertise in quality improvement and patient/member care.

· Knowledge of regulatory compliance.

· Effective resource management.

· Excellent communication and collaboration abilities.

· Oversight of technical support operations.

Why Join Vheda Health?

At Vheda Health, we invest in our team's wellbeing with a comprehensive benefits package:

· Compensation: Competitive salary within the published range plus performance bonus and equity opportunities

· Healthcare: Comprehensive medical, dental, and vision coverage

· Financial Security: 401(k) retirement plan, voluntary life insurance, short and long-term disability

· Work-Life Balance: Unlimited paid time off and 12 paid company holidays

· Community: Engaging team events and activities throughout the year

Base salary range: $68,000–$85,000 per year