Clinical Manager, Navigation Service Delivery

• ROLE

  Were looking for a Clinical Manager Navigation Service Delivery & Innovation. This individual will lead our team of Clinical Health Guides (registered nurses) who help our members navigate their healthcare needs e.g. clinical triage education clinical guidance treatment decision support condition support and overall well-being in driving more informed healthcare consumers improving clinical outcomes and reducing overall healthcare costs.

  This manager is accountable for the day-to-day management of the clinical navigation business group leading and motivating a team of Clinical Health Guides to deliver impactful timely accurate and high-touch concierge-level clinical guidance to our members. The Manager is responsible for delivering against operational KPIs driving quality handling resolution of member/client escalations and overall support of their team operating in our Rightway omnichannel contact center environment.

  This manager in collaboration with delivery leadership will work cross-functionally collaborating across the organization to drive clinical operational innovation clinical outcome impact and product efficiency. This includes supporting our customer success team with client-facing reporting of clinical insights and impact as well as clinical/point solution vendor assessment and partnership oversight.

  RESPONSIBILITIES

  • Lead motivate coach and mentor your team of Clinical Health Guides to deliver world-class concierge-level clinical guidance in a care navigation contact center environment.
  • Support team with complex clinical navigations (member encounters) and offer clinical insight guidance and support. Leaning in to support with medical navigations and other workflows as needed during peak season or as needed based on volume and staffing.
  • Escalation management including resolving member issues root cause analysis developing solutions and communicating resolution plans to key stakeholders and clients as needed.
  • Interview hire onboard train audit and ensure team member adherence to Rightway care navigation model triage and clinical protocols and use of clinical tools e.g. 5-Minute Consult ClearTriage compliance with policies procedures and regulations (HIPAA etc.).
  • Assign review and monitor employee workload to ensure the timely and accurate completion of member interactions. Conduct weekly coaching sessions quality reviews and performance evaluations.
  • Perform daily weekly and monthly reviews of performance analytics to drive member experience identify process improvements and otherwise manage the business.
  • Develop update and maintain Standard Operating Procedures.
  • Develop evidence-based clinical protocols and workflows.
  • Serve as the internal primary clinical point of contact and subject matter expert for the organization (Account Mgmt. Product Data & Analytics Sales etc.)
  • Support new/renewing client launches.
  • Work collaboratively in cross-functional teams to drive operational and product improvements growth and efficiency through partnerships with the navigation leadership PBM delivery team CMO product and data/analytic teams.
  • Supports the client success team with client requests and needs requiring clinical expertise.
  • Supports the client success team as needed with client quarterly business reviews in providing clinical insights and impact for their population.
  • Responsible for evaluating strategic clinical partner vendors as well as oversight and management of our clinical vendor partners e.g. after-hours nurse line telemedicine etc.

  REQUIREMENTS

  • Must have a Registered Nurse or Advanced Practice Registered Nurse active valid license and must have a multi-state/compact license. This candidate should have experience as a nurse manager program administrator and in running clinical programs.
  • Experience developing and executing on public health and/or population health strategies and programs.
  • Demonstrated and direct nurse management experience or equivalent experience required.
  • Disease Mgmt and/or Case Mgmt program experience is highly desirable.
  Candidates must have at least 5 years of experience with direct patient care.
  • Strong and demonstrated coaching and mentoring skills with a passion for developing and growing team members.
  • High level of Emotional Intelligence (EQ).
  • Growth-oriented coachable with a focus on continued professional growth and development.
  • Requires a flexible work schedule including evenings and weekends as needed
  • Strong team-building collaboration and motivational skills.
  • Ability to effectively influence and communicate with all levels of the organization with excellent written and verbal communication skills.
  • Builder and self-starter who is willing to develop SOPs drive innovation product recommendations address operational gaps and continuously look for ways to improve the business and member experience.
  • Highly organized with experience in project management creating roadmaps and executing with accountability.
  • Ability to multitask in a fast-paced environment.
  • Requires experience managing data and deriving insights.

SALARY (BEFORE COMMISSION POTENTIAL): $100000 - $125000

Offer amounts for both remote and in office roles are influenced by geographic location.

CYBERSECURITY AWARENESS NOTICE

In response to ongoing and industry-wide fraudulent recruitment activities (i.e. job scams) Rightway wants to inform potential candidates that we will only contact them from the @ email domain. We will never ask for bank details or deposits of any kind as a condition of employment.

ABOUT RIGHTWAY:

Rightway is on a mission to harmonize healthcare for everyone everywhere. Our products guide patients to the best care and medications by inserting clinicians and pharmacists into a patients care journey through a modern mobile app. Rightway is a front door to healthcare giving patients the tools they need along with on-demand access to Rightway health guides human experts that answer their questions and manage the frustrating parts of healthcare for them.

Since its founding in 2017 Rightway has raised over $205mm from investors including Khosla Ventures Thrive Capital and Tiger Global. Were headquartered in New York City with satellite offices in Denver and Dallas. Our clients rely on us to transform the healthcare experience improve outcomes for their teams and decrease their healthcare costs.

HOW WE LIVE OUR VALUES TO OUR TEAMMATES:

Were seeking those with passion for healthcare and relentless devotion to our goal. We need team members that embody our following core values:

1) We are human first
Our humanity binds us together. We bring the same empathetic approach to every individual we engage with whether it be our members our clients or each other. We are all worthy of respect and understanding and we engage in our interactions with care and intention. We honor our stories. We listen toand heareach other we celebrate our differences and similarities we are present for each other and we strive for mutual understanding.

2) We redefine what is possible
We always look beyond the obstacles in front of us to imagine new solutions. We approach our work with inspiration from other industries other leaders and other challenges. We use ingenuity and resourcefulness when faced with tough problems.

3) We debate then commit
We believe that a spirit of open discourse is part of a healthy culture. We understand and appreciate different perspectives and we challenge our assumptions. When working toward a decision or a new solution we actively listen to one another approach it with a yes and mentality and assume positive intent. Once a decision is made we align and champion it as one team.

4) We cultivate grit
Changing healthcare doesnt happen overnight. We reflect and learn from challenges and approach the future with a determination to strive for the face of daunting situations we value persistence. We embrace failure as a stepping stone to future success. On this journey we seek to act with guts resilience initiative and tenacity.

5) We seek to delight
Healthcare is complicated and personal. We work tirelessly to meet the goals of our clients while also delivering the best experience to our members. We recognize that no matter the role or team we each play a crucial part in our members care and take that responsibility seriously. When faced with an obstacle we are kind respectful and solution-oriented in our approach. We hold ourselves accountable to our clients and our members success.

Rightway is Proudly an Equal Opportunity Employer that believes in strength in the diversity of thought processes beliefs background and education and fosters an inclusive culture where differences are celebrated to drive the best business decisions possible. We do not discriminate on any basis covered by appropriate law. All employment is decided on the consideration of merit qualifications need and performance.