Manager, Clinical Services

Manager, Clinical Services

Allied Benefit Systems

Position Summary:

The Clinical Services Manager provides leadership and oversight to a multidisciplinary team of clinicians — nurses, pharmacists, nutritionists, and other licensed professionals — responsible for conducting case evaluations, identifying opportunities to engage members in improving their health, and submitting referrals to appropriate programs. This role ensures operational excellence, compliance, and continuous improvement in clinical workflows. The supervisor will leverage clinical expertise and analytical skills to review documentation, interpret medical records, understand health plan benefits, and support product implementation initiatives.

• Supervise and mentor a team of clinicians, ensuring adherence to clinical standards, documentation requirements, and organizational policies.
• Oversee case evaluation processes to identify gaps in care, opportunities for member engagement, and appropriate program referrals.
• Provide coaching, performance evaluations, and ongoing professional development opportunities.
• Monitor productivity, quality, and engagement metrics; implement corrective actions as needed.
• Analyze clinical and operational data to identify trends, gaps, and improvement opportunities.
• Prepare and present reports on team performance, member outcomes, and program effectiveness to leadership.
• Collaborate with internal leadership stakeholders to provide clinical recommendations and best practices in development and integration of new products and services.
• Participate in cross‑functional initiatives to enhance member experience and health outcomes.
• Lead, coach, motivate, and develop. Conduct one‑on‑one meetings, performance appraisals, growth opportunities, and attract new talent.
• Clearly communicate expectations, provide employees with the training, resources, and information needed to succeed.
• Actively engage, coach, counsel, and provide timely, constructive performance feedback.
• Other duties as assigned.

• Bachelor’s Degree in Nursing required.
• Registered Nurse or Physician Assistant license required.

• Minimum of 7 years of Clinical Experience preferred.
• Minimum of 1 year of Managed Care/Discharge Planning preferred.
• Experience in Nursing and concurrent review.
• Experience, preferably from a third‑party administrator, carrier, or within the healthcare industry.
• Experience managing teams of employees with a variety of backgrounds and tenure.
• Ability to monitor and prioritize multiple deadlines and projects simultaneously.
• Experience reading, analyzing, and reviewing organizational metrics and data, preferred.
• Highly skilled in written and verbal communication, including client‑focused presentations.

• Accountability
• Communication
• Action Oriented
• Timely Decision Making
• Building Relationships / Shaping Culture
• Customer Focus

• This is a standard desk role – long periods of sitting and working on a computer are required.

• Remote

Base pay range: $/yr - $/yr. Compensation may include benefits including medical, dental, vision, life & disability insurance, generous paid time off, tuition reimbursement, EAP, and a technology stipend.

Remote (must have at least 100

Mbps download/25

Mbps upload connection).

Mid‑Senior level

Full‑time

Health Care Provider