Location: This position is located at our Dublin, OH campus.
Who we are
Founded in 1999 and headquartered in Central Ohio, we’re a privately-owned, independent healthcare navigation organization. We believe that no one should have to navigate the cost and complexity of healthcare alone, and we’re on a mission to make healthcare simpler and more effective for our millions of members. Our big-hearted, tech-savvy team fights to ensure that our members get the care they need, when they need it, at the most affordable cost – that’s why we call ourselves Healthcare Warriors®.
We’re committed to building diverse and inclusive teams – more than 2,000 of us and counting – so if you’re excited about this position, we encourage you to apply – even if your experience doesn’t match every requirement.
About the role
The PCG Operations Lead is responsible for working in partnership with Manager, PCG Operations to ensure smooth and consistent execution of PCG functions and processes. This position will also serve as a leader, coach, and role model to promote Quantum Health’s mission and core values.
What you’ll do
- Responsible for new PCG staff assimilation from cultivation to assigned team
- Assignment of PCG support for cultivation and balancing workload impacts
- Provides ongoing coaching, education and mentorship for PCG clinical staff
- Leads clinical huddles for collaboration of workload and case discussions
- Responsible for monitoring and adjusting daily clinical workload, in conjunction with PCG Operations Manager(s)
- Daily monitoring of PCG productivity and execution towards operational targets
- Identify and serve up any clinical education needs or trends to PCG Operations leadership
- Provide interview support, as needed
- Assist with day-to-day problem-solving, Q&A, and protocol guidance for staff
- Facilitate regular team discussions that reinforce key needs/expectations/initiatives, promote an awareness of program and staff performance
- May provide direct case management services to members based on coverage and workload needs
- Act as subject matter expert to support implementation as it relates to PCG process and protocol
- Act as a subject matter expert to support consultant audits/high-cost case reviews prepared by Clinical Experience Lead, as needed
- Support the PCG Operations Manager(s) in assuring smooth execution of PCG functions and processes within the Pod
- Maintains a working knowledge of all clinical workflows and policies
- Other duties as assigned
What you’ll bring
- Licensure/Certifications: Current and active license as a Registered Nurse in the State of Ohio
- Diverse knowledge base of role and function of all nursing functions within the Pod
- Five years’ clinical experience, with minimal two years of experience leading a team preferred
- Certification in case management preferred or ability to achieve within 3 years of acceptance of position
- Strong ability to communicate effectively with members and providers in implementing clinical services program functions
- Ability to make decisions that achieve results consistent with business goals and organizational culture
- Ability to work independently and self-directed with limited need for day-to-day supervision
- Possess excellent time management skills
- Ability to function in a team environment that requires effective collaboration, role blending & direct communication
- Experience in mentoring and/or coaching in a clinical setting
- Possess excellent verbal and written communication skills
- Strong administrative/technical skills; Comfort working on a PC using Microsoft Office (Outlook, Word, Excel, PowerPoint), IM/video conferencing (Teams & Zoom), and telephones efficiently.
- A high degree of personal accountability and trustworthiness, a commitment to working within Quantum Health’s policies, values and ethics, and to protecting the sensitive data entrusted to us.
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