Clinical Operations- Senior Manager

Clinical Operations Senior Manager

Sagility combines industry‑leading technology and transformation‑driven BPM services with decades of healthcare domain expertise. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.

Job Description

The Senior Manager Operations ensures client satisfaction, retention, and account profitability objectives are met and enhanced. The role involves managing program operations, training and quality, staff development, client management, and safety and security activities.

Education

• College degree in Nursing Management, Marketing, Psychology or Life Science.
• Clinical degree (USRN) with unrestricted license to practice within the United States.

Experience

• 5 years customer service experience.
• 4 years managerial experience.

Mandatory Skills

• People Management / Team Orientation
• Drive for Results / Execution
• Expertise / Analytical Skills
• Product Knowledge
• Problem Solving
• Presentation Skills
• Process Improvement
• Fiscal Management
• Business Acumen
• Change Management
• Planning, Organizing, Controlling

Roles & Responsibilities Operations Management Function

• Monitor daily performance metrics (call handling times, service levels & quality grades) to assure standard compliance.
• Administer program and implement client and in‑house policy with Operations Manager.
• Manage day‑to‑day operations and attend weekly client meetings to discuss performance.
• Interface with clients during visits, present performance and escalation any unusual issues.
• Attend weekly operations reviews, present action plans and respond to operational issues as reported.
• Escalate issues beyond authority to Senior Operations Manager and inform senior leadership as needed.
• Submit weekly and monthly operations review reports to Senior Vice‑President of Operations and clients.

Training & Quality Management / Standards Compliance Function

• Minimize customer complaints to acceptable levels.
• Collaborate with account, staff and senior leadership to develop and implement policies and procedures.
• Recommend and implement process improvements for continuous improvement.
• Ensure compliance with HIPAA, Privacy Rules, HITECH, URAC and other relevant legislation.
• Coordinate training calendar, activities and quality monitoring to meet client standards.

Staff Development Function

• Ensure daily productivity standards are met.
• Provide leadership and motivation to managers and staff.
• Conduct monthly one‑on‑one coaching and weekly manager meetings to review performance.
• Develop succession and incentive plans and support employee satisfaction initiatives.
• Manage account login IDs, reporting and spot‑checks on agent performance.

Client Management

• Interface daily with Vendor Managers to address operational concerns and metrics.
• Coordinate with transition, training, quality, reporting and special projects groups.
• Submit timely reports to clients and manage invoicing documentation.

Other Responsibilities

• Execute tasks assigned by Director or Associate Director.
• Prepare composite reports and communicate operational issues with other departments.
• Manage overall project budgeting, financial planning and client profitability.
• Recruit key personnel from internal and external sources.

General Safety and Security

• Protect organization assets and uphold QI Management System principles.
• Ensure confidentiality, integrity and availability of critical information.
• Maintain compliance with HIPAA, HITECH, URAC and international regulations.

Benefits

• Medical
• Dental
• Vision
• Life Insurance
• Short‑Term and Long‑Term Disability
• Flexible Spending Account
• Life Assistance Program
• 401(k) with employer contribution
• PTO and Sick Time
• Tuition Reimbursement

Join our team, we look forward to talking with you!
An Equal Opportunity Employer/Vet/Disability

Location

Work@Home – USA, United States of America

Seniority Level

• Not Applicable

Employment Type

• Full‑time

Job Function

• Management and General Business

Industries

• Outsourcing and Offshoring Consulting

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