Clinical Team Manager

Clinical Team Manager

We are looking for an experienced and highly motivated Clinical Team Manager to lead our clinical operations team. The ideal candidate will be responsible for overseeing team performance, ensuring compliance with healthcare standards, and driving operational strategies to support quality patient care and service excellence.

Job Description

• Oversee day-to-day clinical team operations and performance
• Develop and implement strategies to improve workflow, productivity, and service quality
• Ensure compliance with organizational policies, healthcare regulations, and industry standards
• Monitor team KPIs, productivity, and quality metrics
• Provide leadership, coaching, and performance management to team members
• Support utilization management and case management processes
• Ensure adherence to MCG / InterQual criteria and Medicare / Medicaid guidelines
• Collaborate with internal stakeholders to achieve business and clinical objectives
• Prepare reports and provide operational insights to leadership

Qualifications

• Bachelor’s Degree in Nursing
• Must have an active PHRN and USRN license
• Minimum 5 years of relevant experience in a managerial role
• Strong background in Utilization Management and Case Management
• Knowledgeable in MCG / InterQual criteria
• Familiar with Medicare and Medicaid guidelines
• Strong leadership, communication, and analytical skills
• Experience handling healthcare / BPO clinical teams is an advantage

Application Question(s):

•    Knowledge of Utilization Management, Case Management, MCG/InterQual criteria, and Medicare/Medicaid guidelines

Education:

• Bachelor's (Required)

Experience:

• Manager: 5 years (Required)

License/Certification:

• USRN and PHRN License (Required)

Work Location: In person