Clinical Operations Asst. Manager (Manager)
Full-time
Gratitude Inc
PROGRAM: Healthcare – Hybrid Voice and Back-Office Operations
WORK LOCATION: Vertis North, Quezon City WORK SETUP: Onsite SHIFT SCHEDULE: US Day Shift SALARY: Open, depending on the candidate's current or previous salary, experienceTARGET START DATE: On or before December 15, 2026 Job Overview Lead a high-performing clinical operations team supporting a major US managed care program. Drive service excellence, clinical quality, and team development in a fast-paced, metrics-driven environment. Key Responsibilities Own daily SLA/KPI performance, including turnaround time, quality, productivity, and documentation Conduct team huddles, interval monitoring, root cause analysis (RCA), and performance recovery planning Ensure strict compliance with HIPAA and PHI requirements Lead clinical quality assurance through audits, calibrations, coaching, and documentation reviews Develop and mentor registered nurses (RNs), clinical associates, and team leaders Manage competency programs, preceptorship, continuing education (CE) tracking, and license validity Collaborate with Workforce Management (WFM), Talent Acquisition (TA), Quality Assurance (QA), and client stakeholders Translate clinical protocol updates into practical workflows and training materials Qualifications Bachelor of Science in Nursing (BSN) graduate with an active Philippine RN license – required Active, unrestricted USRN license (NCLEX passed) – required At least 5 years of clinical and healthcare operations experience – required At least 3 years of team leadership experience in healthcare BPO or shared services – required Strong knowledge of US managed care, Utilization Management (UM), Case Management (CM), CMS, and HIPAA – required Proven experience managing SLAs, KPIs, and clinical operational performance – required Background in Utilization Review (UR)/Utilization Management (UM) with current experience managing UR operations – required Preferred: Experience in UM, CM, Health Risk Assessment (HRA), triage, or payer operations Preferred: Familiarity with URAC/NCQA standards Preferred: Training experience Willing to work onsite on a US day shift USRN License Validity: The license must be active. Candidates whose licenses are nearing expiration must be willing to renew it.
Vacancy posted 23 hours ago
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