SCOPE OF ROLE

The Manager, Clinical Programs Operations, will be responsible for the oversight of vendors and coordination of internal teams that perform operational support function necessary for operational execution of the Clinical Programs.  The position will work across the organization and interface with internal business function for the delivery of clinical operations.  This position will have accountability for program operations and performance, including program functions that are delegated and will directly contribute to the growth and regulatory compliance of Bright Health.

ROLE RESPONSIBILITIES

The Manager, Clinical Program Operations job description is intended to point out major responsibilities within the role, but it is not limited to these items.

• Responsible for the overall management and relationship with external vendors that provide services and activities either delegated and/or support the Clinical Operations department.
• Coordinate, facilitate, and manage all vendor management tasks inclusive of working with external vendors and internal employees. performance of vendors and their operational systems including configuration and customization necessary to support business functions. Troubleshoot all vendor problems and present to management as required.
• Ensure to track, measure, report and evaluate vendor performance. Monitor contractual agreements for all clinical operations vendors and assure that vendor partners effectively manage plus contracts are completely leveraged.
• Develop, coordinate, and manage vendor processes and methods to identify, select, and approve, and/or transition vendors. Take the lead and project managed the implementation of any new vendors.
• Participate, provide oversight, manage the development of workflow processes, policies, procedures, workflows, and correspondence materials for vendors for external and internal activities.
• Understand and collaborate to ensure vendor operations adhere to State and Federal rules and requirements and URAC accreditation standards. Identify improvement areas internally as well as perform closely with all internal stakeholders to prepare solutions. Ensure enterprise-wide needs and identify risks with each vendor relationship and work contracted/completed.
• Identify and implement continuously enhance efficiencies associated with vendor management plus produce fulfillment.
• Identify key cohorts and opportunities for achieving short- and long-term operational goals that support line of business, clinical market performance, and quality via vendors and vendor management.

SUPERVISORY RESPONSIBILITIES

• This position has supervisory responsibilities for the Clinical Operations team.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

• Bachelor’s degree or equivalent combination of education and experience
• Three (3) or more years of progressive healthcare experience required, preferred in utilization management and/or care management.
• Proficient in Microsoft Office suite (Work, PowerPoint, Excel, Outlook, Visio, etc…)

PROFESSIONAL COMPETENCIES

• Ability to scope, develop, and execute a strategic plan and roadmap to achieve operational and organizational goals.
• Skilled in cross-function collaboration and leading in a matrix environment.
• Excel at creating structure and leading operational rigor to teams; passion for creating an effective team environment and resolving conflicts.
• Self-directed and able to prioritize work appropriately and take ownership to drive results.
• Ability to develop a cohesive team culture and develop team members.
• Excellent presentation and communication skills, both written and verbal, demonstrated with peers and leadership.

WORK ENVIRONMENT

The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer. Some travel may be required.