Clinical Operations Manager - Virtual Care Management (RN)

You will lead, through a team of supervisors, the work that stays with patients between visits — following up on test results, completing provider orders, keeping care plans current, and checking in on patients managing chronic conditions. Success in this role is measured by follow-through: patients get what they need when they need it, and nothing is left unfinished.

• Own daily execution of care navigation — case assignment, prioritization, aging, and closure — ensuring each patient’s case is carried cradle to grave by an accountable owner.
• Enforce prioritized workflow standards across time-sensitive work such as returned results, clinical rechecks, order actioning, and returned fax and referral handling.
• Set and manage production expectations, caseload capacity, and turnaround-time standards by task type; monitor queue health daily and reassign before backlogs form.
• Define and maintain role boundaries between RNs, care navigation specialists, clinical leads, and supervisors so escalation paths are unambiguous.

• Oversee longitudinal care management operations, including care plan production, patient outreach cadence, and documentation completeness against program requirements.
• Manage the daily execution of around-the-clock nursing coverage — shift handoffs, overnight production expectations, and weekend and holiday rotations — ensuring the defined minimum presence is met at all times.
• Ensure inbound patient calls are answered and clinically triaged appropriately across all hours, including rollover coverage from adjacent teams.
• Partner with clinical leadership on scope-of-practice, triage protocols, and escalation to providers.

• Oversee an RTM team of medical assistants and licensed practical nurses conducting proactive outreach, medication adherence monitoring, and intervention.
• Manage a ratio-driven caseload model — assign and rebalance panels as census grows, and surface to workforce operations when growth outpaces the staffing plan.
• Ensure clinical concerns are escalated promptly to nursing and provider teams, and that billing and documentation requirements for monitoring services are consistently met.
• Maintain patient-service standards on inbound contact even where no formal service level applies.

• Execute against the published staffing plan across caseload-based, coverage-based, and 24/7 models; make the intraday calls when the day does not go as planned.
• Manage schedule adherence, shift swaps, and same-day absences; approve overtime within plan and escalate anything structural to workforce operations.
• Participate in interviewing, selection, and onboarding for these teams, and flag coverage gaps early so hiring can start on time.

• Build and maintain the operating reporting for these teams — throughput, case aging, adherence, census, and quality — and translate it into specific workflow decisions.
• Coach and develop supervisors and clinical leads on performance management, documentation, and accountability.
• Partner with quality and compliance to meet clinical, HIPAA, and health plan contractual requirements, including audit and gap closure reporting.
• Contribute to workflow design, SOP documentation, testing, and training as programs, plan partners, and platform capabilities are added.

• Lead, develop, and hold accountable a team of supervisors; build bench strength and clear role boundaries between leads and supervisors.
• Own retention for the teams under you — set the expectation that attrition is a managed number, not a weather event.
• Track turnover and understand why people leave; act on what you learn through onboarding, workload, scheduling practices, growth paths, and the quality of frontline supervision.
• Drive employee satisfaction and engagement deliberately, on the understanding that how our staff experience their work is what patients feel on the other end of the call.
• Foster a culture where remote team members are visible, connected, and recognized.

• Active, unrestricted RN license required, with direct patient care experience; multi-state or compact licensure preferred.
• Experience in a virtual care practice or contact center environment is required — telehealth, care management, disease management, population health, or healthcare contact center operations.
• Demonstrated ability to manage multiple concurrent workflows — several distinct teams, queues, and program requirements running simultaneously, each with different rhythms and deadlines.
• Minimum of 3 years of people leadership experience, including managing supervisors or team leads in a clinical or production operations setting.
• Experience managing caseload or panel-based work and holding a team to throughput and turnaround-time standards.
• Experience managing coverage, adherence, and real-time staffing decisions against a published schedule.
• Demonstrated success retaining staff and reducing attrition, ideally in a remote or high-volume environment.
• Strong data fluency — able to build and interpret operational reporting in Excel and dashboards, and act on what it shows.
• Proficiency with EHR/practice management systems, telehealth platforms, care management documentation tools, and CRM systems.
• Understanding of HIPAA, patient privacy, and healthcare compliance obligations in a remote work environment.
• Availability to support 24/7 operations, including weekend and holiday escalation coverage on a rotating basis.