Job Title: Clinical Operations Assistant Manager (Manager)

Work Location: Vertis North, Quezon City
Work Setup: Onsite
Work Shift: US Day Shift
Program: Healthcare – Hybrid Voice and Back-Office Operations
Experience: At least 5 years of clinical and healthcare operations experience, including 3 years of team leadership

Job Overview :

We are seeking an experienced Clinical Operations Assistant Manager to lead a clinical operations team supporting US managed care services. The successful candidate will drive service delivery, clinical quality, operational performance, compliance, and team development in a fast-paced healthcare environment.

Key Responsibilities :

1. Monitor and manage daily service-level agreements (SLAs) and key performance indicators (KPIs), including turnaround time, quality, productivity, and documentation accuracy.

2. Lead team huddles, performance monitoring, root cause analysis (RCA), coaching, and performance recovery initiatives.

3. Ensure compliance with HIPAA, PHI requirements, clinical protocols, and applicable operational standards.

4. Oversee clinical quality through audits, calibrations, documentation reviews, competency programs, continuing education, and license validity tracking.

5. Develop and mentor registered nurses, clinical associates, and team leaders while collaborating with Workforce Management, Talent Acquisition, Quality Assurance, and client stakeholders to improve workflows and operational outcomes.

Required Skills :

1. Clinical operations and healthcare BPO/shared services leadership.

2. Strong knowledge of US managed care, Utilization Management (UM), Utilization Review (UR), Case Management (CM), CMS, and HIPAA.

3. SLA/KPI management, performance monitoring, root cause analysis, and process improvement.

4. Clinical quality assurance, documentation audits, coaching, and competency management.

5. Team leadership, stakeholder management, communication, and operational reporting.

Qualifications :

• Bachelor of Science in Nursing (BSN).

• Active Philippine Registered Nurse (PHRN) license.

• Active, unrestricted USRN license with NCLEX passed.

• At least 5 years of clinical and healthcare operations experience.

• At least 3 years of team leadership experience in healthcare BPO or shared services.

• Current experience managing Utilization Review (UR) operations, with a strong background in Utilization Management (UM).

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