Clinical Operations Manager- VBC

Overview As the largest and leading value-based kidney care company, Somatus is empowering patients across the country living with chronic kidney disease to experience more days out of the hospital and healthier at home. It takes a village of passionate and tenacious innovators to revolutionize an industry and support individuals living with a chronic disease to fulfill our purpose of creating More Lives, Better Lived. Does this sound like you? Showing Up Somatus Strong We foster an inclusive work environment that promotes collaboration and innovation at every level. Our values bring our mission to life and serve as the DNA for every decision we make: + Authenticity: We believe in real dialogue. In any interaction, with patients, partners, vendors, or our teammates, we are true to who we are, say what we mean, and mean what we say. + Collaboration: We appreciate what every person at Somatus brings to the table and believe that together we can do and achieve more. + Empowerment: We make sure every voice gets heard and all ideas are considered, especially when it comes to our patientsu2019 lives or our partnersu2019 best interests. + Innovation: We relentlessly look for ways to improve upon the status quo to continuously deliver new solutions. + Tenacity: We see challenges as opportunities for growth and improvement u2014 especially when new solutions will make a difference for our patients and partners. Showing Up for You We offer more than 25 Health, Growth, and Wealth Work Perks to help teammates learn, grow, and be the best version of themselves, including: + Subsidized, personal healthcare coverage (medical, dental vision) + Accrual of 3 weeksu2019 Vacation (PTO) + Professional Development, CEU, and Tuition Reimbursement + Curated Wellness Benefits supporting teammates physical and mental well-being + Community engagement opportunities + And more The Clinical Operations Manager u2013 VBC is responsible for managing an interdisciplinary team of clinical and non-clinical field team members. This position directs the team to manage affordability and advance clinical quality for patients with kidney disease and congestive heart failure. The Clinical Operations Manager u2013 VBC also supports the engagement of key stakeholders needed to be successful with operational initiatives in the field. The Clinical Operations Manager u2013 VBC is responsible for outcome metrics, productivity, and patient experience related to VBC initiatives. The Manager supports customer relations in the assigned territory of field-based healthcare teams tied to Population Health, affordability, and the value-based kidney care space and works closely with our Provider Engagement Team. This role is a fully remote position with expected travel within a designated regional market. There will be travel requirements for on-site needs to support the care team and practice relationship management. Responsibilities Business & Financial Management: u00b7 Responsible for Profit & Loss (P&L) for the designated regional market. u00b7 Overall knowledge of Profit & Loss (P&L) business management (pricing, financial reporting, census measures, variance reports, labor reports, etc.) in a healthcare setting. u00b7 Utilizes business intelligence reports/tools to manage and enhance business operations u00b7 Maximizing profitability through revenue generation, expense control, and ongoing market analysis. u00b7 Setting targets and supporting the region's quality and financial performance, evident through growth in the regionu2019s contribution and quality outcomes. u00b7 Collaborates with Population Health leadership on forecasting and aligning staffing needs. u00b7 Works with actuary team and VBC leadership to complete year-end reconciliation. Provider & Practice Relationship Management: u00b7 Primary relationship owner with medical practices in the region, responsible for fostering positive relationships and support to VBC groups. u00b7 Conducts checks with practices appropriate to size of practice volume (weekly, monthly). u00b7 Reports to leadership on health of VBC partnership, relationship and implement strategies for remediation, mitigation, and improvement as needed. u00b7 Engages with Provider Partners to drive quality and operational outcomes, identifying opportunities for improvement and action plans and providing Clinical Quality reviews, QAPI, Scorecard or JOC at necessary frequency per provider partnership size. u00b7 Drive the IDT and QAPI meetings with practice partnerships, with an increasing understanding of cost drivers, impacting ways care teams can impact and bring cost over time. Promote wellness, prevention, chronic care management. u00b7 Collaborates and coordinates new workflows for new partnerships. u00b7 Provides necessary Somatus program information education at implementation for dedicated office staff, NPs, and physicians for success of the program. u00b7 Coordinates Somatus care team introductions and walk-throughs of process workflows to ensure understanding of onsite needs and decrease interference in physician office workflows. u00b7 Provides Somatus program refreshers for new hires for partnerships or as needed for realignment. Care Team Supervision & Performance Management u00b7 Supervises the VBC care team of field-based nurse care managers, social workers, Patient Health Advocates, and dietitians and monitors performance, growth, and development. u00b7 Manages staff adherence to Somatus VBC contractual goals, workflows, protocols, best practices, and documentation expectations via documentation and call audits. u00b7 Manages transitional care team assessments for members within the VBC partnership in assigned region(s) to support members throughout transitions of care (inpatient, SNF, home, etc.) to prevent avoidable admissions and re-admissions. u00b7 Audit care team documentation to drive improvements and audit recorded calls for coaching opportunities and quality performance. u00b7 Performs shadow visits in the field as needed to support performance improvement. u00b7 Creates on-call schedules for the care team (if needed). Operations & Program Support: u00b7 Understands and ensures compliance with all contractual requirements and differences and accreditation needs as VBC partnerships operate under all clients. u00b7 Work cross functionally with other departments like product and technology to develop and refine VBC- specific workflows, training materials, policies, and other materials related to the VBC program. u00b7 Supports training, advancing the clinical model and re-training efforts, and identifies gaps where additional staff training/coaching is needed; facilitates ongoing training in the market. u00b7 After training, show proficiency in Somatus care management and RenalIQ applications. u00b7 Supports the Director of Operations in tracking Somatus monthly, quarterly, and end of year Payor partner requirements and standard reports. u00b7 Supports data collection, report preparation, and material creation for Somatus payer partner meetings, including Joint Operating Committees (JOC). u00b7 Works with market leadership to track market progress to goals for engagement, quality, SLAs, etc. u00b7 Review, manage, and coordinate case assignments with care teams for identified patient populations. u00b7 Reports/resolves issues and system barriers to efficient and effective care. u00b7 Participates in care team meetings, performance improvement, and patient satisfaction initiatives. u00b7 Utilizes population management data and resources to identify patients at risk and facilitate appropriate support and resources. u00b7 Maintains compliance with organizational policies, procedures, and evidence-based guidelines. u00b7 Ensure pertinent patient information and performance reports are appropriately shared with customers. u00b7 Oversees an effective communication link between patients and medical staff, including relaying messages from providers and gathering information from patients for providers. u00b7 Coordinates with Operations Director to track and share data with corporate teams and customers on patient outcomes measures and performance against outcomes and financial goals. u00b7 Working collaboratively with Technology, Finance, Population Health Product & Innovation, and Human Resources. _Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice._ Qualifications Required Education and Experience: u00b7 Bacheloru2019s degree in nursing or similar health-related field. u00b7 Clinical Licensure: RN. u00b7 5u20137 years of program management experience or operational experience in population health, managed care, case management, or healthcare consulting, particularly in value-based care. u00b7 Understanding of value-based contracting and healthcare quality. u00b7 Overall knowledge of Profit & Loss (P&L) business management (pricing, financial reporting, census measures, variance reports, labor reports, etc.) in healthcare settings. u00b7 Functional knowledge of outpatient healthcare operations, ideally in nephrology, dialysis, or primary care. u00b7 Proven ability to effectively interact and engage with internal and external stakeholders. u00b7 Experience working cross functionally with remote teams. u00b7 Ability to work on multiple projects simultaneously with minimal supervision and meet deadlines in a fast-paced environment. u00b7 Enjoys working collaboratively with team members. u00b7 Highly effective written and verbal communication skills, including presentation skills and relationship building. u00b7 Demonstrates empathy, enthusiasm, and a strong work ethic. u00b7 Proficiency with Microsoft Office Suite, including Excel, PowerPoint, MS Project, Visio. u00b7 Must possess strong problem-solving abilities and analytical skills. u00b7 Ability to travel up to 50% throughout the assigned region(s) to shadow staff and travel to HQ as needed. u00b7 Experienced clinical profit and loss (P&L) leader with the ability to oversee budgeting, reporting, planning, and auditing. Preferred Education and Experience u00b7 Masteru2019s degree in Business or Healthcare or related field. u00b7 Strong working knowledge of the Somatus Care Model and workflows. u00b7 Experience in population health/value-based care, especially management of chronic health conditions like kidney and chronic heart disease. Knowledge, Skills, and Abilities u00b7 Strong interpersonal and customer service skills are required to communicate with patients, family members, physicians, and other healthcare providers, as well as other colleagues. u00b7 Must possess strong problem-solving abilities and analytical skills. u00b7 Demonstrates, after training, the ability to use all applicable electronic systems/applications including population management systems to input, retrieve, and manipulate clinical information. u00b7 Must be highly attentive to detail, accuracy, and achieving end results. u00b7 Utilizes critical thinking and good judgment in performance of tasks. u00b7 Must possess good organizational skills and the ability to multitask and prioritize daily assignments to ensure smooth workflow. u00b7 Intermediate skills with Microsoft applications which may include Word, Excel, PowerPoint, and other web-based applications. May produce complex documents, perform analysis, and maintain databases. u00b7 Understands and comply with the highest standards of confidentiality. u00b7 Positive and inspiring team leadership style to drive outcomes while driving a culture of excellence by keeping team members engaged. u00b7 Knowledge and experience to coach team members, empower patients in self-management and shared decision-making. u00b7 Ability to travel throughout the assigned region(s) to shadow staff and travel to HQ as needed. Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.Our priority is the health and safety of our members, colleagues, partners, and community. Proof of COVID-19 Vaccination is required for employment. If you are unable to be vaccinated for medical reasons or sincerely-held religious beliefs, we will consider requests for reasonable accommodations consistent with our policy, and where we are able to provide such accommodations without undue hardship to the company pursuant to applicable law.Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Somatus, Inc. provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by state, federal, or local law. Further, the company takes affirmative action to ensure that applicants are employed, and employees are treated during employment without regard to any of these characteristics. Discrimination of any type will not be tolerated.

Created: 2025-10-06