Supervisor - RN Clinical
- Experience Level
- Experienced (non-manager)
The Supervisor - RN Clinical is responsible for managing the daily operations of the clinical team in the area of medical management operations, inclusive, but not limited to maintaining production metrics, delivering on current service level agreements, fulfilling contractual requirements and supporting future state initiatives while meeting strategic, operational and budgetary targets. Additionally this position will partner with leadership to continue the development of clinical quality programs. In collaboration with key business partners, the Supervisor – RN Clinical will identify operational opportunities and areas for process development, improvement and administration applicable to clinical product offerings and present recommendations to leadership. Supervises and coordinates daily activities of business support, technical support or production team at entry level and/or at non-exempt levels using established policies and procedures. Sets priorities for the team; Coordinates work activities with other supervisors and managers. Work is reviewed for soundness of decision-making and overall quality and efficiency.
Specific job duties:
- Monitor operational performance relating to Operational metrics, Quality measures, Contractual requirements, Execution of MBM policies and procedures and Clinical appropriateness.
- Monitor the daily administration of clinical programs, including application of medical policy, utilization management processes and practices while remaining compliant with contractual and regulatory requirements.
- Serve as a point of escalation for issues requiring a higher degree of expertise or discretion to resolve.
- Provides department leadership in the area of staff performance including mentoring, auditing, productivity monitoring and coaching for success. Corresponds with management on employee/HR issues, state of the department and any service issues involving key clients or legal risk issues to the company.
- Analyze reporting data trends within team relative to quality to ensure efficiency and productivity requirements are maximized. Provide feedback to team related to productivity and efficiency.
- Continual identification of operational opportunities to gain efficiencies, improve processes and workflow and develop best practices.
2 – 5 Direct Reports
Desired Skills and Qualifications:
- Bachelor’s degree in relevant discipline or equivalent experience
- 2 – 5 years relevant experience or Master’s degree
- Registered Nurse License in good standing in the state in which you work and/or cross-licensed in other states
- Telephonic nursing roles must have (or be willing to obtain) a compact nursing license; additionally, the employee must be willing to obtain additional state licenses upon request.
- Solid PC navigation skill set
- Working knowledge of Microsoft Office
- Excellent verbal and written communication and presentation skills
- Solid understanding of the health insurance industry
- Ability to navigate and support both public and private insurance/plan requirements
- Managed care exposure
- Understanding or ability to implement utilization management principles
- Proven leader in a clinical ops environment
United BioSource Corporation (UBC) is a leading provider of pharmaceutical support services, partnering with life science companies to make medicine and medical products safer and more accessible. Our services support the full lifecycle of medicine and medical products, including development, commercialization, and long-term value and safety.
While UBC offers employment within Patient Support, Nursing, Pharmacy and Corporate, two main focus areas for the company are Clinical Development & Research and Safety & Risk Management. Members of the Clinical Development and Research teams help evaluate study protocol, target study population, recruit physicians and patients, and collect, clean, validate and report data. As a result, sponsors are able to submit findings to regulatory authorities or make a no-go decision in a timely and clear-cut manner. Additionally, our Safety and Risk Management teams develop, deliver, and report evidence to reinforce safe and appropriate product use.
Through our Patient Access services, we help patients begin therapy quickly and remain on therapy, building strong relationships with patients to ensure optimal care.
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