Nursing Supervisor

Supervisor - RN ClinicalThe Supervisor - RN Clinical is responsible for managing the daily operations of the clinical team in the area of medical management operations, inclusive, but not limited to maintaining production metrics, delivering on current service level agreements, fulfilling contractual requirements, and supporting future state initiatives while meeting strategic, operational and budgetary targets. Additionally, this position will partner with leadership to continue the development of clinical quality programs. In collaboration with key business partners, the Supervisor – RN Clinical will identify operational opportunities and areas for process development, improvement, and administration applicable to clinical product offerings and present recommendations to leadership. Supervises and coordinates daily activities of business support, technical support, or production team at entry level and/or at non-exempt levels using established policies and procedures. Sets priorities for the team, Coordinates work activities with other supervisors and managers. Work is reviewed for soundness of decision-making and overall quality and efficiency.Specific job duties: Monitor operational performance relating to Operational metrics, Quality measures, Contractual requirements, Execution of policies and procedures and Clinical appropriateness.Monitor the daily administration of clinical programs, including application of medical policy, utilization management processes and practices while remaining compliant with contractual and regulatory requirements.Serve as a point of escalation for issues requiring a higher degree of expertise or discretion to resolve.Provides department leadership in the area of staff performance including mentoring, auditing, productivity monitoring and coaching for success. Corresponds with management on employee/HR issues, state of the department and any service issues involving key clients or legal risk issues to the company.Analyze reporting data trends within team relative to quality to ensure efficiency and productivity requirements are maximized. Provide feedback to team related to productivity and efficiency.Continual identification of operational opportunities to gain efficiencies, improve processes and workflow and develop best practices.Ability to travel as neededActively participates in in-person and virtual meetings (internal and external)Supervisory Responsibility: 1-20 Direct ReportsDesired Skills and Qualifications:Bachelor's degree in relevant discipline or equivalent experience2 – 5 years relevant experience or master's degreeRegistered Nurse License in good standing in the state in which you work and/or cross-licensed in other statesTelephonic nursing roles are required to have a Compact State License in eligible states; additionally, employee must be willing to obtain Compact State license at such time as their state elects to adopt Compact legislationTelephonic nursing roles are required to have a California State License, and the employee must be willing to obtain additional Single State Licenses upon request.Solid PC navigation skill setWorking knowledge of Microsoft OfficeExcellent verbal and written communication and presentation skillsSolid understanding of the health insurance industryAbility to navigate and support both public and private insurance/plan requirementsManaged care exposureUnderstanding or ability to implement utilization management principlesProven leader in a clinical Ops environmentBenefits:At UBC, employee growth and well-being are always at the forefront. We offer an extensive range of benefits to ensure that you have everything you need to thrive personally and professionally.Here are some of the exciting perks UBC offers:Remote opportunitiesCompetitive salariesGrowth opportunities for promotion401K with company match*Tuition reimbursement (after 90 days of employment)Flexible work environmentDiscretionary PTO (Paid Time Off)Paid HolidaysEmployee assistance programsMedical, Dental, and vision coverageHSA/FSATelemedicine (Virtual doctor appointments)Wellness programAdoption assistanceShort term disability (after 90 days of employment)Long term disabilityLife insuranceDiscount programsUBC is proud to be an equal opportunity employer and does not discriminate because of race, color, sex, age, national origin, religion, sexual orientation, gender identity and/or expression, status as a veteran, and basis of disability or any other federal, state, or local protected class. We are committed to a diverse, equitable and inclusive culture that fosters respect for each other, our clients, and our patients.