Supervisor – Clinical Operations, Nurse

🔥 1 minute ago

🏄 California, Colorado, +9 more states – Remote

🏄 California – Remote ⛰️ Colorado – Remote 🦌 Connecticut – Remote 🦞 Maine – Remote 🦬 Montana – Remote 🗽 New York – Remote 🌲 Oregon – Remote 🔔 Pennsylvania – Remote 🍁 Vermont – Remote ☕ Washington – Remote 🦬 Wyoming – Remote

💵 $92.7k - $117.2k / year

⏰ Full Time

🟢 Junior

🏥 Clinical Operations

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GEHA Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1937

⚕️ Healthcare Insurance

🧘 Wellness

🏛️ Government

Healthcare Insurance • Wellness • Government

GEHA Health is a large benefits association dedicated to serving federal employees, retirees, and their families. Founded by postal workers in 1937, GEHA offers a comprehensive range of health and dental plans, including FEHB and PSHB options, as well as additional benefits such as gym memberships, vision benefits, and wellness rewards. With a network of 1. 7 million providers nationwide and extensive prescription drug coverage, GEHA prioritizes reinvesting profits to enhance member experiences and support federal workforce health. Their plans include Medicare Advantage options and a robust telehealth offering, ensuring their members receive the best possible care and coverage.

📋 Description

• Owns and oversees day-to-day process across the organization for their specific workstream, and ensures staff compliance with program workflows, clinical documentation, benefit resource allocation, and work distribution. • Responsible for oversight of complex or escalated case investigations and notifies department leadership as appropriate. • Coordinates department workload and identifies staffing needs or other resources to meet quality, quantity, and departmental goals. • Communicates changes in departmental processes and procedures to staff when necessary. • Serves as primary contact for staff, assigned internal and external programs and escalated issues. • Identifies potential process improvement opportunities across departments and makes recommendations to leadership as appropriate. • Audits staff processes and reviews cases with staff to assess compliance with established clinical and clinical support guidelines, workflows, and adherence to benefits structure and applicable regulations. • Consults with the leadership regarding complex and/or high-profile cases. • Recommends promotion, termination, hiring or reassignment of subordinates including scheduling and conducting informal and formal employee performance reviews, coaching and competency assessments. • Leads performance management, coaching, and talent development to build a high‑performing, engaged team. • Reviews performance issues with leadership and makes recommendations regarding level of discipline including developing performance improvement plans and delivering disciplinary action after reviewing with leadership and Human Resources. • Develops, implements, and maintains internal policies and procedures. • Coordinates department project planning to accommodate the company's annual business needs. • Works with management team to develop future programs and goals. • Collaborates with clinical staff and Medical Director regarding medical cases to ensure services are clinically appropriate. • Assists with development of department training materials. • Identifies educational opportunities for the staff. • Collaborates with Clinical Operations Division educator to provide educational opportunities. • Uses performance metrics and data analysis to identify trends, drive continuous improvement, and improve outcomes.

🎯 Requirements

• Requires a bachelor’s degree in clinical field for which the team has responsibility (Example: Nursing teams would need a BSN) • Associates degree in a related health field may be considered with 5 years of experience • Active/Good standing RN license, including accountability for maintaining all requirements of licensing post hire, must be eligible to be licensed in all US states and territories • 1-3 years leadership experience • Demonstrates excellent verbal and written communications skills • Shows strong collaboration skills and the ability to build productive working relationships • Displays a high level of self-initiative and independent problem-solving skills. • Preferred: Nursing experience in Fertility, Obstetrics, Labor, and Postpartum care. • Case Management experience is preferred • Must have the ability to provide a non-cellular High Speed Internet Service such as Fiber, DSL, or cable Modems for a home office. A minimum standard speed for optimal performance of 30x5 (30mpbs download x 5mpbs upload) is required. • Latency (ping) response time lower than 80 ms • Hotspots, satellite and wireless internet service is NOT allowed for this role. • A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

🏖️ Benefits

• Health/Vision/Dental benefits effective day one • 401(k) retirement plan: company match – dollar for dollar up to 4% employee contribution (pretax or Roth options) plus a 6% annual company contribution • Robust employee well-being program • Paid Time Off • Personal Community Enrichment Time • Company-provided Basic Life and AD&D • Company-provided Short-Term & Long-Term Disability • Tuition Assistance Program