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 (CCMu2019s)
Lead, motivate, and develop assigned clinical case manager staff
Assess and monitor clinical case manageru2019s 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 Alightu2019s 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 employeru2019s 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.