What are the responsibilities and job description for the Manager Clinical Services Operations position at Cambia Health Solutions?
Manager Clinical Services Operations
Work from home within Oregon, Washington, Idaho or Utah
Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.
Who We Are Looking For:
Every day, Cambia’s dedicated team of Clinical Services leaders are living our mission to make health care easier and lives better. As a member of the Clinical Services team, our Manager Clinical Services Operations manages a team including subordinate supervisors that is responsible for various functions within the clinical services ops departments such as: Clinical intake and correspondence, pre-authorization support, project and process management, documentation and training. Provides technical guidance, assistance and coordination of all operational activities within Clinical Services. Ensures cost effective accomplishment of their department(s), the overall Clinical Services division, and Cambia corporate goals and the effective operation of daily activities – all in service of making our members’ health journeys easier.
As a people leader, you are willing to learn and grow, understanding that leadership is a craft that is continuously honed as you support your team and the lives that depend upon us.
Are you a healthcare leader passionate about making a difference in people's lives? Do you have a knack for operations management and a desire to lead a team of dedicated professionals? Then this role may be the perfect fit.
What You Bring to Cambia:
Qualifications:
Manager Clinical Services Operations would have a Bachelor’s degree in Business, Healthcare or related field
7 years of experience in healthcare operations and 4 years of leadership experience or equivalent combination of education and experience
Skills and Attributes:
Ability to effectively develop and lead multiple teams including: hiring, goal setting, coaching and development (including supervisors and/or employees who may be in multiple locations or work remotely).
Demonstrated experience managing people, projects, and processes within a service and operational environment.
Ability to identify issues, opportunities, and effect solutions and collaborate with other departments to approve processes and/or results.
Solid understanding and knowledge of health plan operations systems and processes.
Familiarity with health insurance industry trends and technology, including applicable State and Federal regulations and mandates.
Knowledge of medical terminology.
Demonstrated ability to organize, plan, prioritize and drive multiple activities with time constraints in a high-volume production environment.
Ability to communicate effectively with a diverse group of stakeholders, both verbally and in writing, including meeting facilitation and presentations.
Demonstrated competency in resource and project management: budgeting, organizing work, providing leadership to staff, establishing measures for success, and managing to deliverables.
What You Will Do at Cambia:
Leads the development and execution of clinical services operations policies, procedures, and standards, ensuring quality and service excellence through policy updates and process improvements.
Oversees staff management activities, including performance reviews, employee development, hiring, coaching, counseling, and retention, while developing supervisors and participating in talent management activities.
Communicates organizational objectives and team goals, monitoring results and metrics to ensure deliverables are met and in compliance with department and regulatory standards, contract obligations, and collaborating with other leaders to resolve issues.
Manages financial targets, department budget, and workforce allocation, authorizing expenditures, monitoring resources, and overseeing project plans, while establishing long-term goals for the department with division leadership.
Develops and implements departmental and training programs, ensuring program quality and successful outcomes, and creates visibility and support for clinical services operations programs through resource materials, education, and communication.
Ensures compliance with laws, regulatory procedures, accreditation standards, and contract obligations, accurately anticipating and forecasting resource needs, including staffing, to execute assigned objectives.
Represents the unit and division in corporate-wide, cross-functional teams and work groups, managing electronic systems, attending training and development activities, and participating in RFP requests.
As a member of our strong leadership community, you will provide direction to your team, engage them towards common goals and create a positive experience that helps people flourish.
FTEs Supervised
25-75
#LI-Remote
The expected hiring range for a Manager Clinical Services Operations is $100,300 - $135,700 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 15% . The current full salary range for this role is $94,000 to $154,000.
About Cambia
Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100 year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through.
Why Join the Cambia Team?
At Cambia, you can:
- Work alongside diverse teams building cutting-edge solutions to transform health care.
- Earn a competitive salary and enjoy generous benefits while doing work that changes lives.
- Grow your career with a company committed to helping you succeed.
- Give back to your community by participating in Cambia-supported outreach programs.
- Connect with colleagues who share similar interests and backgrounds through our employee resource groups.
We believe a career at Cambia is more than just a paycheck – and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more.
In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include:
- Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
- Annual employer contribution to a health savings account.
- Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
- Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).
- Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
- Award-winning wellness programs that reward you for participation.
- Employee Assistance Fund for those in need.
- Commute and parking benefits.
Learn more about our benefits.
We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.
We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.
If you need accommodation for any part of the application process because of a medical condition or disability, please email CambiaCareers@cambiahealth.com. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.
Salary : $94,000 - $154,000
