WellSky

Sr. Team Lead, Clinical Operations - RN - Remote

United States

Not SpecifiedCompensation
Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, Health InsuranceIndustries

Requirements

Candidates must possess a Bachelor's Degree or equivalent work experience and have 4-6 years of clinical nursing or therapy experience. An active RN license is required. Preferred qualifications include 1-2 years of experience in utilization review, case management, and/or managed care regulations, as well as experience with clinical decision support tools like MCG or InterQual, particularly in utilization management and prior authorization processes. A general understanding of managed care guidelines and their impact on services is also preferred. Candidates must be able to pass federal and state required background checks and drug screens, be willing to travel up to 30% based on business needs, and work additional or irregular hours as needed. They must also adhere to security policies and procedures and be able to sit and view a computer screen for extended periods.

Responsibilities

The Sr. Team Lead, Clinical Operations is responsible for overseeing a team of clinicians and other clinical support staff, coordinating and delivering care to patients under payer programs, and managing daily operations to ensure efficiency and accuracy. This role involves identifying and addressing operational challenges, supporting work plan development and task assignment, and managing larger, more complex clinical programs. The position also includes providing enhanced training and mentorship to team members, collaborating with managers on recruitment and performance feedback, and analyzing team performance data to recommend process improvements. Additionally, the role requires developing relationships with healthcare providers and clients to improve health outcomes, applying clinical knowledge for care coordination, complying with all standard operating procedures and policies, and consulting with peer reviewers and Medical Directors to ensure medically appropriate, quality, and cost-effective care. Other job duties as assigned are also part of the responsibilities.

Skills

Clinical Operations
Team Leadership
Care Coordination
Utilization Review
Microsoft Office Suite
Excel
Clinical Decision Support Tools
Operational Software
Coaching
Mentoring

WellSky

Healthcare software and community care solutions

About WellSky

WellSky offers software and services to improve health and community care, making it easier for providers and patients to access and navigate care. Its products, like the WellSky Value Based Care Suite, integrate with Electronic Health Record (EHR) systems to enhance care coordination. WellSky stands out by providing a comprehensive range of solutions, including strategic consulting and revenue cycle management, which help clients operate more efficiently. The company's goal is to enhance care delivery and improve individuals' quality of life through effective solutions.

Reston, VirginiaHeadquarters
1980Year Founded
$34.5MTotal Funding
DEBTCompany Stage
Social Impact, HealthcareIndustries
1,001-5,000Employees

Benefits

High deductible health plan with a generous employer contribution
PPO medical plan
Dental and vision insurance
401(k) plan with access to financial advisors who can provide personal financial guidance at no cost
Robust paid time off, including holidays, vacation, well-being, and volunteer days
Flexible spending accounts (medical and dependent)
Life and disability insurance
Educational assistance
Employee Assistance Plan with free and confidential emotional, financial, legal, and family resources

Risks

Integration challenges with acquisitions like Bonafide may cause operational inefficiencies.
Data privacy issues may arise from collaborations in the nonprofit sector.
Dependency on third-party systems increases exposure to partners' operational risks.

Differentiation

WellSky offers comprehensive solutions across the full continuum of care.
The company integrates with any EHR system to improve care coordination.
WellSky's services include strategic consulting, compliance, and revenue cycle management.

Upsides

Growing demand for integrated care solutions boosts WellSky's market potential.
Value-based care models align with WellSky's offerings, enhancing growth opportunities.
Acquisitions like TapCloud enhance patient engagement and reduce costs.

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