Manager, Clinician Services

Summary

Join Included Health as the Manager of Clinician Services to lead the team responsible for credentialing, privileging, licensing, and peer review activities. You will set strategic goals, ensure efficient and compliant processes, and drive continuous improvement. This remote role requires collaboration with various departments and adherence to NCQA standards. You will manage staff, monitor budgets, and analyze key metrics to enhance efficiency and reduce operational costs. The position reports to the Director of Clinician Services and offers a competitive salary and benefits package.

Requirements

• Bachelor's Degree
• Minimum of 5 years of experience in Medical Staff Services with at least 3 years in a people management role
• Strong people management and motivational skills
• Excellent verbal and written communication skills
• Excellent interpersonal skills and ability to interface effectively across multiple teams
• Excellent time management skills with a proven ability to meet deadlines
• Ability to drive teams' results and prioritize their activities in alignment with business objectives
• Strong analytical and problem-solving skills
• Ability to function well in a high-paced environment and able to quickly adapt to change

Responsibilities

• Oversee day-to-day operational credentialing, privileging, and licensing activities, collaborating with the Credentialing Committee, Clinician Review Committee, and Clinical Operations team
• Provide strategic and operational oversight of the clinician peer review process, serving as the primary liaison and collaborative partner to the Chair of the Clinician Review Committee
• Partner with Go-To-Market and Enrollment teams to develop and implement standardized processes for new customer and payer initiatives
• Champion and lead initiatives to drive significant process improvement and operational efficiencies across all areas of clinician services
• Conduct regular workflow analysis to identify bottlenecks, redundant steps, and areas for automation, implementing solutions that enhance productivity and reduce operational costs
• Establish and monitor key performance indicators (KPIs) related to efficiency, using data to inform continuous improvement efforts and demonstrate tangible gains
• Manage the selection and management of staff while fostering a culture aligned with IH's core values
• Ensure credentialing processes are in compliance with NCQA, state, and federal regulatory requirements and delegated credentialing agreements
• Provide oversight of the clinical supervision/collaboration program and partner with the Compliance and Clinical leadership team to ensure ongoing compliance with state-specific regulations
• Maintain oversight of ongoing monitoring, compliance, and re-certification activities for accrediting organizations
• Identify, prioritize, and implement workflow and technology/product enhancements to improve licensing and credentialing efficiencies and clinician satisfaction
• Analyze, report, and present recommendations on various key metrics and trends related to the clinician onboarding process and credentialing/licensing
• Participate in and present recommendations around strategic planning and annual goal setting
• Monitor and manage the allocated budget for Clinician Services operations, ensuring cost-effectiveness and resource optimization

Benefits

• Remote-first culture
• 401(k) savings plan through Fidelity
• Comprehensive medical, vision, and dental coverage through multiple medical plan options (including disability insurance)
• Full suite of Included Health telemedicine (e.g. behavioral health, urgent care, etc.) and health care navigation products and services offered at no cost for employees and dependents
• Generous Paid Time Off ("PTO") and Discretionary Time Off ("DTO")
• 12 weeks of 100% Paid Parental leave
• Family Building Benefit with fertility coverage and up to $25,000 for Surrogacy & Adoption financial assistance
• Compassionate Leave (paid leave for employees who experience a failed pregnancy, surrogacy, adoption or fertility treatment)
• 11 Holidays Paid with one Floating Paid Holiday
• Work-From-Home reimbursement to support team collaboration and effective home office work
• 24 hours of Paid Volunteer Time Off ("VTO") Per Year to Volunteer with Charitable Organizations