Manager, Clinical Services Business Insights

Manager, Clinical Services Business Insights

Provides oversight of strategy, auditing, training, analytics, and reporting for the Clinical Services business unit. Responsible for daily oversight of monitoring programs, managing department projects and internal and external reporting of Clinical Services programs. Ensures Clinical Service programs and processes align with applicable regulatory standards including Centers for Medicare and Medicaid (CMS), Dual Eligible Special Needs Plans (DSNP) Model of Care (MOC), Health Care Authority (HCA), and National Commission for Quality Assurance (NCQA).

To be successful in this role, you :

• A bachelor's degree in a relevant field such as Public Health, Health Informatics, Business Administration, or a related discipline; a relevant master's degree, such as MPH, MHA, MBA, or MS in Analytics is highly preferred.
• Have five (5)+ years of progressive experience in project management, program management, or healthcare analytics with at least three (3) years in a leadership or supervisory role, required.
• Have a minimum of three (3) years of working experience at a Managed Care Organization (MCO), required.
• Have experience managing large scale projects with both clinical and non-clinical stakeholders, required.
• Have experience as a strategic partner to clinical leadership, translating business needs into technical requirements and ensuring outputs are aligned with operational priorities.
• Professional certifications demonstrating expertise in project management, analytics, or process improvement preferred.

Essential functions and roles and responsibilities :

Knowledge, skills, and abilities :

As part of our hiring process, the following criteria must be met :

Compensation and benefits :

The position is FLSA Exempt and is eligible for overtime. Based on market data, this position grade is 69 and has a 10% annual incentive target based on company, department, and individual performance goals.

CHPW offers the following benefits for Full and Part-time employees and their dependents :

Sensory / Physical / Mental Requirements :

Sensory :

Physical :

Mental :

Work Environment :

Office environment Employees who frequently work in front of computer monitors are at risk for environmental exposure to low-grade radiation.