The Clinical Program Manager will work closely with the clinic staff and the Health Plan to ensure that the day to day business and operational components of the clinic are run in a smooth and professional manner.  The manager will oversee all aspects of daily clinic operations to ensure that the clinic is providing high quality, effective and efficient clinical care; with a customer centric focus and in accordance with all HealthSpring policies and procedures. The manager will be responsible for development and implementation of business strategies to build strong relationships with referring physicians to increase visit numbers and positively affect revenue growth.   

Core Responsibilities/Essential Functions

• Strong knowledge base of the purpose of the LivingWell and what services are offered
• Proficient in the current HEDIS/P4Q/Stars measures and understanding of how a Medicare Advantage plan works
• Adheres to HIPAA guidelines and maintains confidentiality
• Maintains a positive professional relationship with the staff, referring providers, community groups, the health plan and enterprise teams
• Be available to patients for any questions or concerns that occur in the clinic
• Hire and Build a high quality clinical and service-oriented team
• Manage/oversee daily operations of a multi-disciplinary team; which includes scheduling/registration, clinic flow, documentation, and patient satisfaction.
• Analyze clinic workflow/efficiency and develop action plan for changes; where needed
• Print and review reports that identify visit numbers, open orders, reporting trends and patterns to identify opportunities for improvement
• Develop good core relationships with oversight physician and referring providers to drive volume
• Oversee the daily schedules to ensure that visit times are being booked and utilized to capacity
• Overall direction/coordination/evaluation of site
• Interview, hire, train employees, monitor and evaluate staff performance and rewarding/disciplining employees
• Know and adhere to all Policies and Procedures established by HealthSpring
• Work with staff to develop/implement ideas for higher quality and cost effective services
• Review/monitor staffing levels/productivity
• Conduct monthly employee staff meetings
• Ensure that the facility is clean, maintenance is done in a timely manner and the area is safe
• Keep a log of equipment and ensure it is in good working order
• Work with key health plan staff on budget development and management of operation for compliance with site budget; including CLIA and liscensure compliance
• Facilitates compliance with local/federal regulations and corporate Standard Operating Procedures
• Develops action plan if deviation from compliance policies
• Implement/maintain OSHA compliance, training, and policies/procedures. 
• Maintain employee files, professional licenses/affiliations for sites, control overtime, evaluate/educate needs of staff
• Conduct ongoing clinical training according to HealthSpring policy and individual clinic needs
• Attend all mandated meeting and disseminate the information to clinical staff, when directed

Minimum Qualifications

• LPN, LVN, RN or bachelor degree in health related field or business administration
• Minimum of 7 years experience in case management, medical management, or utilization management with 3+ years of management of clinical staff
• Organizational initiatives
• Experience in application of business principles to clinical practice
• Valid state drivers’ license

Preferred Requirements

• Electronic health record experience 
• RN/BSN
• MBA MHA

This role is patient facing & you must be fully vaccinated OR be required to undergo testing twice a week. Note, in some locations local law requires the clinician to be vaccinated with no testing option, in those locations local law takes precedent.
 

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you’ll enjoy meaningful career experiences that enrich people’s lives. What difference will you make?

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.