Clinical Operations Manager

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.

Clinical Operations Manager

Job title:

Clinical Operations Manager

Job Description:

DUTIES & RESPONSIBILITIES:

Shift Management Function:

• Monitors daily all areas of performance metrics (call handling times, service levels & quality grades) to assure that standards are met across the board referring to a database, a program or reports.
• Works with Shift Managers to administer program and implement both client and in house policy.
• Ensures that operations are being managed accordingly on a day-to-day basis.
• Attends client meeting on a weekly basis or as needed to discuss the program performance based on the key operational metrics.
• Interface with client during visits, do presentation regarding performance of the program if need be and escalate issues that are out of the ordinary.
• Attends weekly operations review and present action plans to issues that need to be addressed.
• Collates and responds to operational issues as reported by Shift Managers ? as needed.
• Escalates operational issues beyond level of authority to the Department Head ? as needed.
• Informs the Department Head when the system needed (system error/downtime) to handle calls are not working effectively ? as needed.
• Submits weekly and monthly ops review report to the Department Head.

Quality Management/Standards Compliance Function:

• Minimizes or manages at acceptable level the customers? complaints
• Works with the Department Head to further develop program and implement policy ? as needed.
• Works with the Shift Managers and all Support Managers in coordination with other groups in coming up with programs that will help further develop the associates.
• Recommends new or modifications to existing procedures to ensure Continuous Process Improvement (CPI).
• Evaluates management and contact center practices for possible modifications that will result in increased employee efficiency and satisfaction.
• Responsible for the development and implementation of policies and procedures pertaining to HIPAA and ensures the center is in compliance with Privacy Rules Standard.

Staff Development Function:

• Ensures that the Contact Center meets productivity standards ? daily.
• Provides daily leadership and motivation to a team of at least 2 Shift Managers.
• Conducts monthly one-on-one coaching to Shift Managers and provide feedback to drive performance and reduce cost using data from reports on Attendance, handling time, productivity and quality grades.
• Devises strategic communication plan to ensure all changes are relayed on time and accurately.
• Creates incentives for all staff in conjunction with meeting performance measurements.
• Conducts weekly meeting with Shift Managers and discusses team and program performance, issues and share best practices.
• Designs development plans for Shift Managers; Prepares for succession plan in case the position got vacated in the future.
• Initiates and supports all employee satisfaction and workplace programs.
• Consults personnel / program issues to the Department Head in terms of further decision-making.
• Coordinates with client for login ID upgrades due to promotion and/or deletion of network IDs from the system for voluntary/involuntary attrition.
• Regularly spot-checks agents on customer handling and provides TLs/Quality Personnel with feedback on areas for improvement.

Others:

• Performs tasks assigned by the Department Head.
• Prepares composite reports from the individual reports of subordinates.
• Communicates as needed with other departments within the Contact Center about operational and personnel issues.
• Handles the overall project, budgeting & financials, strategies to improve teams KPIs, SPOC for the client relations, profitability of the project, planning & process improvements.

Work At Home Responsibilities

• Be familiar with and abide to all Sagility general security and Work @ Home security policies and procedures
• Be familiar with and abide by all client security policies and procedures required to protect customer data
• Maintain the security of the home work environment and protect the Sagility-provided assets, client system and data
• Ensure that all security related incidents are reported
• Shall work on the same internet connection that was tested during setup process. If changes are made to the current internet connection or router during the course of application or employment, employee will be required to notify the appropriate parties in advance and retest the connection to ensure the requirements are met.
• Must immediately report system performance problems or downtime to his/her manager and the local IT-SPOC

General Safety and Security

• Protects the organization?s assets by upholding the principles of the Quality Information Security Management System (QISMS).
• Ensures confidentiality, integrity, and availability of information critical to fulfilling the organization?s business functions.
• Ensures confidentiality, integrity, and availability of information critical to fulfilling the organization?s business functions.
• Ensures compliance to the relevant business, local and international regulatory and legislative requirements particularly the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Health Information Technology for Economic and Clinical Health Act (HITECH), and Utilization Review Accreditation Commission (URAC).

COMPETENCY REQUIREMENTS:

With Moderate Competency Level in ff.:

• Communication Skill (Spoken)
• Communication Skill (Written)
• Customer Service Orientation
• Computer Literacy
• Job Knowledge
• Sense of Urgency
• Passion for Excellence
• Working in Teams/ Interpersonal Skills
• Work Organization
• Thriving in Change
• Problem Solving
• Facilitation Skills
• Coaching
• Performance Management
• Discipline Management
• Conflict Management
• Fiscal Management
• Business Acumen
• Planning, Organizing, Controlling

With Expert Competency Level in ff.:

• People Management/ Team Orientation
• Drive for Results/ Execution
• Expertise/ Analytical Skills
• Product Knowledge
• Presentation Skills
• Process Improvement
• Change Management

OTHER REQUIREMENTS:

Reports to: Senior Operations Manager / Director for Operations / Senior Director for Operations

Supervises:

Shift Managers

Education and/or Experience:

Any 4-yr College Degree and/or equivalent experience

5 years customer service experience, 2 year managerial experience.

Although not required, an active USRN or PHRN license is a preferred

Language Skills:

English, additional language a plus

Computer Skills:

MS Office, Planning, Controlling, Organizing and Management Skills

Reasoning Ability:

Must be able to problem solve, and determine problems, also to recommend solutions. To seek out better methods of training classes to operate. Strong People Management, customer orientation and Analytical skills.

Work environment (B&M):

The work environment is professional, office. Business casual attire.

Work environment (WAH):

• Workstation PC is located in a confined area at home
• PC monitor is not facing the door or window
• Room is well ventilated to reduce the risk of equipment overheating
• Unauthorized entry to room is prevented (i.e. keeping the room locked at all times)
• Telephone conversations are not overheard from other areas of the house/outside
• Workstation is clean and free from any form of writing materials and electronic device
• Adequate internet connectivity (> 50 mbps)

Physical demands:

May require weekend or evening work.

Location:

Quezon City, Bridgetowne ZetaPhilippines