Clinical Business Systems Operations Manager (Remote)

$116,240 - $215,771/Yr

CareFirst of Maryland - Baltimore, MD

Full-time - Mid Level

Remote - Baltimore, MD

Ambulatory Health Care Services

About the position

The Clinical Business Systems Operations Manager will oversee all aspects of systems operations for the clinical platform, Guiding Care, which supports Care Management, Utilization Management, and Appeals and Grievance. This role is crucial for ensuring system optimization and availability in a high-demand environment, while also managing a team responsible for configuration setup, system testing, and issue resolution. The position requires collaboration with various departments to align system functionalities with CareFirst Plan requirements and to support operational reporting needs.

Responsibilities

• Manage the team's leadership and planning efforts.
• Hire, motivate, coach, counsel, and develop team members.
• Evaluate performance of team members and generate performance plans.
• Develop and manage the team's budget.
• Ensure successful completion of day-to-day changes and corporate initiatives.
• Manage team resources for effective Systems Development Life Cycle (SDLC) activities.
• Oversee production systems support and monitoring processes.
• Document operational systems processes and create process documents with peer managers.
• Prepare day-to-day operations performance reports by analyzing data and trends.
• Direct and participate in planning sessions to coordinate operations with other departments.
• Develop project management plans for corporate initiatives and other projects.
• Provide resource estimates, timeframes, and assist with budget development for projects.
• Oversee corporate processes for systems change management.

Requirements

• Bachelor's Degree in Business Administration or related field, or 4 additional years of relevant work experience in lieu of a degree.
• 5 years of Business Analysis experience.
• 1 year of supervisory or progressive leadership experience.
• Working knowledge of Tableau, Power BI, and ServiceNow ticketing system.

Nice-to-haves

• Familiarity with health insurance operations and/or healthcare systems.
• Direct experience with the Guiding Care platform.
• Progressive experience in system operations with functional testing teams.

Benefits

• 401(k)
• 401(k) matching