Location: New York, NY, United States | Type: Remote | Country: USPosition:Manager of Clinical Business Operations Location: Hybrid(Must Reside in NY/NJ/CT) Work Schedule:Monday - Friday, 9:00am - 5:00pm Compensation:$118,135.58 - $132,902.53 Annual Salary Our Purpose VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years. Scope of the Role The Manager of Clinical Business Operations ensures Utilization Management non-clinical operations meet CMS and NYSDOH requirements while supporting departmental quality assurance and business objectives. Reporting to the Director of Utilization Management, you will guide non-clinical staff performance, translate regulatory expectations into workable processes, and help drive consistent, audit-ready outcomes. Key responsibilities include monitoring non-clinical productivity and deliverables; supporting utilization management projects and departmental initiatives tied to regulatory alignment; developing and updating policies and communicating operational impacts to upstream and downstream stakeholders; providing administrative subject matter expertise; contributing to corrective action plans; identifying operational risks and partnering on mitigation plans; and supporting additional initiatives as directed. Required Qualifications3+ years in Utilization Management/Managed Care with Medicare/Medicaid UM quality monitoring and regulatory processes (non-clinical)Strong leadership, communication, and stakeholder-management skillsAbility to analyze data, measure outcomes, and escalate action plansComfort working quickly, prioritizing effectively, and meeting deadlinesStrong computer/software proficiency; Bachelor's degree preferredApply to help strengthen compliant, high-performing clinical business operations. How Your Day Flows Your day typically begins by reviewing dashboards and recent outputs to confirm non-clinical work is tracking to expected standards, then connecting with team members to remove blockers and reinforce consistent documentation practices. You'll spend focused time interpreting new or updated CMS/NYSDOH guidance, translating it into clear internal messaging, and aligning timelines with partners who depend on UM operational outputs. As priorities shift, you may join working sessions to calibrate monitoring approaches, draft or refine policy language, and prepare concise summaries that clarify downstream impacts. You'll also set aside time to coach and develop staff through targeted feedback and short learning touchpoints. Later, you'll consolidate observations into practical recommendations for leadership, ensuring issues are surfaced early and next steps are well-defined-while keeping work organized within a Monday-Friday schedule and with work-from-home flexibility. *Job Posted by ApplicantPro*
14 days ago