Healthmap Solutions is looking for an RN Regional Manager, Clinical Services in San Diego, CA. You will be responsible for planning, directing, and overseeing the performance of a team of assigned Provider and Member facing staff. This role is key to overseeing the clinical and quality activities that build strong engagement and improve health outcomes.
What You'll Do
- Function as an ambassador for the organization with all internal and external customers.
- Collaborate with the team to engage providers and members, serving as an escalation point for difficult situations.
- Implement organization policies, procedures, and workflows to drive team performance.
- Ensure collaboration among multi-disciplinary teams to maximize customer engagement and improve member outcomes.
- Monitor Key Performance Indicators (KPIs) to identify trends and guide regional strategy.
- Develop action plans and remediation strategies to address areas of opportunity.
- Develop, monitor, and report on team performance and productivity.
- Monitor practice profiles monthly to ensure newly attributed members are appropriately assigned.
- Troubleshoot technical issues within Compass and/or Tableau as needed.
- Promote continuous improvement through team audits, provider practice visits, and monitoring member calls.
- Develop ongoing team education to address skill and competency gaps.
- Develop, coach, and mentor team members to achieve company, department, and individual goals.
- Conduct yearly performance evaluations and provide constructive feedback.
- Maintain team performance according to National Committee for Quality Assurance (NCQA) standards.
- Comply with HIPAA privacy laws, all other regulations, and company security policies.
- Provide recommendations to leadership regarding necessary operational adjustments.
- Perform other related duties as assigned.
What We're Looking For
- Bachelor's degree required.
- Active, unrestricted RN license required.
- Basic Life Support (BLS) certification required.
- Advanced Cardiovascular Life Support (ACLS) certification (based on role).
- Minimum of two years progressive supervisory and/or management experience required.
- 5 years of progressive experience in healthcare services, clinical operations, quality, or care management required.
- Must reside in the Regional Territory.
- Proof of valid and unrestricted driver’s license required.
- Must comply with organization policies for health screening and immunizations, including but not limited to: Current Tuberculosis (TB) test or current chest X-ray, Proof of immunizations (e.g., Hepatitis B, MMR, Varicella, COVID-19, Influenza), Participation in annual health and wellness screenings.
Nice to Have
- Master’s degree preferred.
- 5 years of experience in closure of care gaps or care coordination preferred.
- Prior experience building and managing relationships with health care providers or patients preferred.
Technical Stack
- Microsoft Office: Outlook, Word, Excel, PowerPoint
- Compass
- Tableau
Team & Environment
You will oversee the performance of a team of assigned Provider and Member facing staff, reporting to Leadership.
Benefits & Compensation
- Compensation: $135,000 - $165,000
- Paid Time Off
- Medical, Dental, and Vision coverage
- Short Term/Long Term Disability
- 401K with match
- Other voluntary benefits as elected
Work Mode
This is a hybrid position based in San Diego, CA.
Healthmap Solutions is an Equal Opportunity Employer. We will not discriminate against any job candidate or employee due to age, race, religion, ethnicity, national origin, gender, gender identity/expression, sexual orientation, disability, familial status, veteran status, marital status, parental status, or pregnancy.
