Clinical Operations Manager - Virtual Care Management; RN

Clinical Operations Manager
- Virtual Care Management (RN)

United States

Job Title:
Clinical Operations Manager
- Virtual Care Management (RN)

Location: Remote
- United States

Employment Type:FT Exempt

Care Talk Health

Care Talk Health is a virtual-only national medical practice delivering chronic care management and preventive care to Medicare members through health plan partnerships. The Clinical Operations Manager for Virtual Care Management owns the operations that carry a patient forward after the visit — care navigation, longitudinal chronic care management, and remote therapeutic monitoring.

About the Role

You will lead, through a team of supervisors, the work that stays with patients between visits — following up on test results, completing provider orders, keeping care plans current, and checking in on patients managing chronic conditions. Success in this role is measured by follow-through: patients get what they need when they need it, and nothing is left unfinished.

Key Responsibilities

Care Navigation Operations

• Own daily execution of care navigation — case assignment, prioritization, aging, and closure — ensuring each patient’s case is carried cradle to grave by an accountable owner.
• Enforce prioritized workflow standards across time-sensitive work such as returned results, clinical rechecks, order actioning, and returned fax and referral handling.
• Set and manage production expectations, caseload capacity, and turnaround-time standards by task type; monitor queue health daily and reassign before backlogs form.
• Define and maintain role boundaries between RNs, care navigation specialists, clinical leads, and supervisors so escalation paths are unambiguous.

Chronic Care & 24/7 Care Management

• Oversee longitudinal care management operations, including care plan production, patient outreach cadence, and documentation completeness against program requirements.
• Manage the daily execution of around-the-clock nursing coverage — shift handoffs, overnight production expectations, and weekend and holiday rotations — ensuring the defined minimum presence is met at all times.
• Ensure inbound patient calls are answered and clinically triaged appropriately across all hours, including rollover coverage from adjacent teams.
• Partner with clinical leadership on scope-of-practice, triage protocols, and escalation to providers.

Remote Therapeutic Monitoring (RTM)

• Oversee an RTM team of medical assistants and licensed practical nurses conducting proactive outreach, medication adherence monitoring, and intervention.
• Manage a ratio-driven caseload model — assign and rebalance panels as census grows, and surface to workforce operations when growth outpaces the staffing plan.
• Ensure clinical concerns are escalated promptly to nursing and provider teams, and that billing and documentation requirements for monitoring services are consistently met.
• Maintain patient-service standards on inbound contact even where no formal service level applies.

Intraday Staffing & Coverage

• Execute against the published staffing plan across caseload-based, coverage-based, and 24/7 models; make the intraday calls when the day does not go as planned.
• Manage schedule adherence, shift swaps, and same-day absences; approve overtime within plan and elevate anything structural to workforce operations.
• Participate in interviewing, selection, and onboarding for these teams, and flag coverage gaps early so hiring can start on time.

Performance & Compliance

• Build and maintain the operating reporting for these teams — throughput, case aging, adherence, census, and quality — and translate it into specific workflow decisions.
• Coach and develop supervisors and clinical leads on performance management, documentation, and accountability.
• Partner with quality and…