Vendor Operations Lead
Grow TherapyFull Time
Senior (5 to 8 years), Expert & Leadership (9+ years)
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.
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.
Healthcare software and community care solutions
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.