Home State Health · 6 hours ago
Lead Clinical Operations Specialist
United States
Full-time
Remote
Mid, Senior Level
$87K/yr - $161K/yr
5+ years expHome State Health is a diversified national organization focused on transforming the health of communities. They are seeking a Lead Clinical Operations Specialist to oversee clinical functions, implement initiatives, and ensure compliance with quality guidelines and mandates.
Health CareHospitalInsurance
Responsibilities
Leads and oversees the implementation of clinical initiatives and/or programs to improve care coordination, efficiency, and health and quality outcomes
Identifies, manages, and tracks clinical, quality, documentation and data submission projects to achieve strategic objectives
Collects and analyzes data on utilization, outcomes, safety, and costs to determine trends and help identify areas of improvement
Reviews development plans, policies, and procedures needed for strategic initiatives, programs with senior leadership team, and improve processes and/or health and quality outcomes based on collected data
Provides guidance and insight to clinical operations junior team members on clinical processes and initiatives
Develops reporting for senior leadership team on data needed to support and monitor initiatives and programs and provides recommendations to improve member experience, improve the quality of care, and reduce health care costs
Works with senior leadership team to support clinical initiatives and/or programs are in accordance with National Committee for Quality Assurance (NCQA) guidelines, state mandates, and/or government contract requirements
Works cross functionally to identify areas for process improvements to manage costs and support initiatives to improve health and quality outcomes
May Assist care operations senior leadership team with onboarding, hiring, and training clinical operations team members
Performs other duties as assigned
Complies with all policies and standards
Qualification
Required
Bachelor's degree
5 – 7 years of related experience
Behavioral health and program development experience
Ability to lead and oversee clinical functions and implement clinical initiatives and/or programs
Experience in improving care coordination, efficiency, and health and quality outcomes
Ability to identify, manage, and track clinical, quality, documentation and data submission projects
Experience in collecting and analyzing data on utilization, outcomes, safety, and costs
Ability to review development plans, policies, and procedures for strategic initiatives
Experience in providing guidance and insight to junior team members on clinical processes
Ability to develop reporting for senior leadership on data needed to support initiatives
Experience in working cross-functionally to identify areas for process improvements
Ability to assist with onboarding, hiring, and training clinical operations team members
Compliance with all policies and standards
Benefits
Health insurance
401K
Stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Flexible approach to work with remote, hybrid, field or office work schedules
Company
Home State Health
Home State Health offers Medicaid, health insurance, health benefits and services for individuals and families.
201-500 employees
Funding
Current Stage
Growth StageRecent News
Missouri Business Alert
2025-09-24
2025-07-22
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