Manager of Clinician Services

Employment Type: Full-Time Location: Remote Reports to: Director of Clinician Services Exempt Position

Position Overview

The Manager of Clinician Services leads the team responsible for all credentialing, privileging, licensing, and peer review activities. This critical role involves setting strategic goals and operational plans to ensure efficient and compliant processes, driving continuous process improvement, and achieving significant efficiency gains within clinician services. The Manager will ensure compliance with NCQA standards and delegated credentialing agreements for various health plans and collaborate with the Included Health Credentialing Committee, Clinician Review Committee, Compliance Department, and Quality Department.

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.

Qualifications

• Bachelor's Degree
• Minimum of 5 years of experience in Medical Staff Services
• Minimum of 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 adapt quickly to change

Compensation

Salary Range: $109,000 - $184,000 per year

New Hire Base Salary Target Ranges (United States):

• Zone A: $108,890 - $141,560 + equity + benefits
• Zone B: $119,779 - $155,716 + equity + benefits
• Zone C: $130,668 - $169,872 + equity + benefits
• Zone D: $141,557 - $184,028 + equity + benefits

This range reflects the minimum and maximum target for new hire salaries for candidates based on their location.