Manager, Clinical Navigation Service Delivery (Contact Center Manager)

ABOUT RIGHTWAY

Rightway is the leader in driving healthcare value for everyone, everywhere through smart clinical navigation, best-in-class technology, and the lightest lift client experience.

Rightway’s care navigation and new-to-the-world PBM platforms have revolutionized the way members traverse the confusing healthcare landscape. With us, employers can provide employees and their families with the education, navigation, and advocacy they need to be better healthcare consumers.   We simplify the healthcare journey and guide members to the highest quality care and medication, leading to better care and happier people at lower cost.

Started in 2017, Rightway is rapidly growing and has raised over $130mm to date from investors including Khosla Ventures, Thrive Capital, Tiger Global, and others. We are headquartered in New York City, with satellite offices in Miami and Denver. Empowered by a talented team of medical experts, pharmacists, entrepreneurs, tech experts, engineers, and strategists, we’re making our vision of radically simplifying healthcare, a reality.

ROLE

We’re looking for a Manager, Clinical Navigation Service Delivery to lead a team of Clinical Health Guides compromised of RNs and/or NPs who help our members navigate their healthcare needs, e.g. clinical triage, education, clinical guidance, treatment decision support, condition support, and overall well-being, in driving more informed healthcare consumers, improving clinical outcomes, and reducing overall healthcare cost. 

You will be accountable for the day-to-day management of the business group and lead/motivate your team of Clinical Health Guides to deliver timely, accurate, and high-touch concierge services to our members. Managers are responsible for handling escalations, driving quality, and supporting their teams who operate in an omnichannel contact center environment.

RESPONSIBILITIES

• Lead, motivate, coach, and mentor your team of Clinical Health Guides to deliver world-class concierge service (typically leads a team of 8-15 employees)
• Develop evidenced-based clinical protocols and workflows
• Serve as an FPOC (First Point of Contact) for the organization for Clinical questions and needs
• Support team with complex clinical navigations (member encounters) and offer clinical insight, guidance, and support. Processing medical navigations and other workflows as needed during peak season or as needed based on volume and staffing 
• Escalation management including resolving member issues, researching root causes and developing solutions, and communicating plans to key Rightway stakeholders and clients as needed
• Train, audit, and ensure adherence to triage and clinical protocols and use of clinical tools, e.g.  5-Minute Consult and ClearTriage
• Assign, review, and monitor employee workload to ensure the timely and accurate completion of member requests 
• Perform daily, weekly and monthly reviews of performance analytics to drive member experience, identify process improvements, and otherwise manage the business
• Develop, update and maintain Standard Operating Procedures to support team and department
• Work collaboratively in cross-functional teams to drive training, quality, workforce, and Product improvements 
• Serve as a clinical subject matter expert for your member base for internal teams (Account Mgmt., Product, Sales, etc.)
• Conduct weekly coachings sessions, quality reviews, and performance evaluations 
• Interview, hire, and onboard new team members
• Ensure compliance with policies, procedures, and regulations (HIPAA, etc.).
• Support new organization launches, refresher training, and account-specific 
• Support program growth and efficiency through partnerships with the Director of Clinical Innovation, our PBM delivery team, and the CMO

REQUIREMENTS

• Valid RN or NP  license required with the preference of having multi-state lic.
• Previous clinician management experience or equivalent experience required
• Disease Mgmt and/or Case Mgmt program experience is highly desirable. 
• Internal candidates must have 9+ months in their current position
• Strong coaching and mentoring skills with a passion for developing and growing team members
• High level of Emotional Intelligence (EQ)

• Coachable, focused on continued growth and development
• Ability to work a flexible schedule including evenings and weekends as needed
• Strong team-building, collaboration, and motivational skills
• Ability to effectively influence and communicate to all levels of the organization, with excellent written and verbal communication skills
• Builder and self-starter who is willing to develop SOPs, drive system recommendations, address operational gaps, and continuously look for ways to improve the business and member experience
• Highly organized, with experience in project managing, creating roadmaps, and executing with accountability
• Ability to multi-task in a fast-paced environment
• An analytical background, with experience analyzing data (agent level performance, queue data, and overall business performance metrics) to identify gaps and actionable insights

Rightway is a healthcare company looking to improve healthcare outcomes for everyone, everywhere. With that in mind, we have to consider what is good for the health of our team, the company, and the communities we operate in. As such, Rightway has determined a mandatory COVID-19 vaccination policy for all employees, in combination with other safety precautions, is the best way forward.

Rightway is PROUDLY an Equal Opportunity Employer that believes in ‘strength in the diversity of thought processes, beliefs, background and education’ and fosters an inclusive culture where differences are celebrated to drive the best business decisions possible. We do not discriminate on any basis covered by appropriate law. All employment is decided on the consideration of merit, qualifications, need and performance.

Target Salary $100,000-$110,000