Clinical Operations Coordinator
: Job Details :

Under the supervision of the VP of Clinical Services this position is responsible for implementation of any clinical program integrations within the Clinical Services Department. This role will be coordinating, monitoring and providing program and staff training to ensure compliance with all regulatory standards. Oversees day to day operations and assists clinical staff serving as a subject matter expert for all clinical operations. Oversees and directs project implementation and directs and assists with new staff training as well as on-going staff education. Required:

Bachelors Degree in healthcare related field or willingness to obtain.

Strong oral and written communication and leadership skills, team building and problem solving.

Considerable knowledge of all clinical services operations and documentation systems.

Ability to analyze data and employ techniques to obtain maximum effectiveness, efficiency and information.

Ability to interpret policies and execute them accordingly.

Ability to coordinate effectively various functions and activities for maximum cooperation and efficiency.

Ability to direct, advise and instruct staff in their current roles.

Demonstrates experience with health insurance products, understanding federal regulations.

5+ years in Managed Care Setting.

Proficiency of database and reporting tools such as Microsoft Word, Excel and PowerPoint.

Desired:

Project management experience preferred.

Responsibilities:

Manage new product development and management alongside key interdepartmental leaders.

Responsible for assessing and fielding questions for all staff in clinical services.

Manage all vendor implantations and integrations including reporting, compliance, planning, coordination and education with other departments as well as analyzing current functionality issues and reporting issues to vendors or clients.

Work with new staff onboarding including submitting capabilities, access to systems, ensuring email groups are appropriate and schedules are completed with direct supervisor or manager.

Plan, lead and train on all systems used by clinicals services as well as field operational and system related questions from all clinical staff and determine the best solution.

Assist THP's Med Econ team to develop and maintain dashboards and reports that meet regulatory requirements and allow for managing operational oversight and management of individual and team performance.

Assist clinical leadership to develop workflow strategies for health risk assessments and distribution to staff by risk score.

Participate in clinical audits for DSNP, CMS, NCQA and Qlarant as needed.

Provide training, coaching, and monitoring of care plan interventions and interdisciplinary care team processes that drive member outcomes using evidence-based technique.

Direct interface with THP fulfillment vendors Zelis and Morgantown Printing.

Manage and monitor THP licensed professionals, assisting with TRC healthcare, and license monitoring to ensure compliance.

Monitor compliance related to letter formatting and Medicare OMT process.

Design and implement improved processes and operations for all aspects of clinical services.

Assist THP IT data team with synchronizing data sets between vendors to ensure accuracy of all information submitted.

Assist all leadership staff with report generation and production.