CLIENT DESCRIPTION

More than a revenue cycle management company – we're a strategic partner for growth. With expert services complemented by AI-enabled technologies and high-touch support, we are the premier revenue cycle partner for leading health systems, physician groups, and academic medical centers in the U.S.

Our global team of more than 12,000 specialists serves over 150 customers across a variety of care settings, specialties, and billing systems.

JOB DESCRIPTION – Clinical Operations Team Lead

The Clinical Operations Team Lead will be responsible for leading up to 15 team members and overseeing day-to-day operations to ensure consistent performance in productivity, SLAs, quality, and turnaround time (TAT). This role is key in fostering employee engagement and maintaining high-quality service delivery.

Key Responsibilities:

• Daily Operations Management: Oversee the daily operations of production teams, ensuring accurate and timely completion of tasks according to client-specific guidelines.
• Compliance Monitoring: Ensure team adherence to all relevant healthcare regulations, including CMS guidelines and client-specific requirements, with the goal of maintaining 100% compliance.
• Operational Strategy Development: Develop and implement strategies to streamline processes, reduce costs, and enhance service quality. Regularly evaluate and improve workflows for better efficiency.
• Resource Allocation: Effectively manage staffing, tools, and technologies to meet variable demands and client expectations.
• Site Management: Oversee site and virtual operations, ensuring optimal functionality of all systems and tools supporting team activity.
• Data Analysis & Reporting: Analyze operational data to identify trends and support data-driven decision-making. Prepare and present regular performance reports to senior management and clients.
• Team Engagement & Support: Provide floor support, lead team meetings and one-on-one check-ins, address concerns, and align team goals. Train and educate team members on new processes and protocol adherence.

CANDIDATE PROFILE

Academic & Professional Background:

• Medical Doctor (Mexico or other countries): Medical Degree (MD) from a recognized university, with at least 3 years of clinical experience. OR
• Registered Nurse (Global): Bachelor's or Master's degree in Nursing from an accredited institution, with at least 5 years of clinical experience.

Preferred Experience:

• Minimum 2 years of experience in one or more of the following areas:
• Utilization Review
• Clinical Documentation Improvement (CDI)
• Clinical denials and appeals
• Physician advisory services
• At least 2 years in a leadership role, managing remote teams in healthcare or BPO environments.
• Strong knowledge of healthcare regulations (e.g., CMS) and proven compliance.
• Experience using revenue cycle software and data analysis tools.
• Certifications (preferred): Case Management (CCM), Utilization Review (URAC), CDI, or related fields.

Core Competencies:

• Leadership: Ability to inspire and manage remote teams, handle conflict, and drive performance.
• Communication: Excellent verbal and written communication skills for team, client, and executive-level interactions.
• Analytical Thinking: Skilled at analyzing complex data and applying insights to improve outcomes.
• Time Management: Efficiently manage tasks and deadlines in a fast-paced environment.
• Problem Solving: Proactively identify and resolve service or compliance issues.
• Team Development:Mentor and coach team members to build a high-performance culture.
• Technical Proficiency: Familiarity with revenue cycle platforms, healthcare systems, and virtual tools.
• Bilingual: Fluency in written and spoken English is required.
• Compliance-Oriented:Understanding and adherence to policies including HIPAA, information security, and HR standards.

WORKING SCHEDULE

• Monday to Friday – 7:00 a.m. to 4:36 p.m.
• Tuesday to Saturday – 7:00 a.m. to 4:36 p.m.

Training Schedule:

• Monday to Friday – 7:00 a.m. to 4:36 p.m.