Manager of Clinical Business Operations

VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years.

About the Role

The Manager of Clinical Business Operations ensures Utilization Management non-clinical operations meet CMS and NYSDOH requirements while supporting departmental quality assurance and business objectives. Reporting to the Director of Utilization Management, you will guide non-clinical staff performance, translate regulatory expectations into workable processes, and help drive consistent, audit-ready outcomes.

Responsibilities

• Monitor non-clinical productivity and deliverables
• Support utilization management projects and departmental initiatives tied to regulatory alignment
• Develop and update policies and communicate operational impacts to upstream and downstream stakeholders
• Provide administrative subject matter expertise
• Contribute to corrective action plans
• Identify operational risks and partner on mitigation plans
• Support additional initiatives as directed

Qualifications

• 3+ years in Utilization Management/Managed Care with Medicare/Medicaid UM quality monitoring and regulatory processes (non-clinical)
• Strong leadership, communication, and stakeholder-management skills
• Ability to analyze data, measure outcomes, and escalate action plans
• Comfort working quickly, prioritizing effectively, and meeting deadlines
• Strong computer/software proficiency
• Bachelor's degree preferred

How Your Day Flows

Your day typically begins by reviewing dashboards and recent outputs to confirm non-clinical work is tracking to expected standards, then connecting with team members to remove blockers and reinforce consistent documentation practices. You'll spend focused time interpreting new or updated CMS/NYSDOH guidance, translating it into clear internal messaging, and aligning timelines with partners who depend on UM operational outputs. As priorities shift, you may join working sessions to calibrate monitoring approaches, draft or refine policy language, and prepare concise summaries that clarify downstream impacts. You'll also set aside time to coach and develop staff through targeted feedback and short learning touchpoints. Later, you'll consolidate observations into practical recommendations for leadership, ensuring issues are surfaced early and next steps are well-defined.

Pay

$118,135.58 - $132,902.53 Annual Salary

Schedule

• Monday - Friday, 9:00am - 5:00pm
• Hybrid (Must Reside in NY/NJ/CT)
• Work-from-home flexibility