Clinical Operations

• Lead a care team of Therapists and Care Extenders to implement programs, serve members, and deliver outcomes to health plan partners
• Work alongside Therapists and Care Extenders to build their skills and directly support members in challenging situations
• Create personalized service plans using member screenings, conversations, data, and community-resource knowledge
• Guide members in managing problems and triggers, increasing relapse prevention, and reducing risk
• Encourage members to develop work skills and participate in therapeutic, social, and recreational activities
• Educate members about mental and physical illness, abuse, violence prevention, medication, and community resources
• Monitor, evaluate, and document member progress against measurable goals
• Maintain accountability communications regarding upcoming appointments
• Coordinate with members, families, physicians, and other providers to reduce unnecessary resource utilization
• Report critical incidents and quality-of-care issues
• Build communication strategies for engaging the member cohort and supporting member goals
• Assess risk and perform crisis intervention according to safety plans
• Develop and coordinate community resource guides focused on medical health, behavioral health, violence prevention, and social services
• Ensure member diagnoses and service plans are comprehensive and appropriate
• Lead CareMind teams to assess member needs, maintain care plans, and support progress toward program graduation
• Coordinate caseloads and referrals and ensure team schedules meet program needs
• Participate in screening, interviewing, and hiring team members
• Provide orientation and training, conduct performance reviews, and continuously coach the team
• Lead enrollment activities to build new markets or maintain current cohorts
• Ensure the team meets key performance indicators and delivers outcomes for members and health plan partners
• Review documentation for quality and training purposes
• Analyze team performance, identify gaps, and create improvement plans
• Collect and synthesize member-outcome data to support training, market understanding, partner relationships, and results
• Lead internal case review sessions and participate in external case management meetings with health plan partners
• Maintain program-related and administrative data, reports, statistical records, and other data collection
• Partner with billing to review claims for accurate reflection of services provided

Clinical Operations jobs in Nevada

Clinical Program Manager, Interpersonal Violence Reduction