Director of Clinical Operations

About Sagility

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members.

The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics.

Sagility has more than 25,000 employees across 5 countries.

Job title:

Director of Clinical Operations

Job Description:

Sagility is a global leader specializing in augmenting healthcare teams to better patient, member, business and financial outcomes in partnership with payers and providers.

A Leader who can interact closely with members and patients to deliver evidence-based, timely, preventative, personalized, cost-effective care with focus on the whole person that improves health, value and overall quality of life.

We are currently hiring a Director of Clinical Operations to join our team!

Skills Required:


* Finance & Budgeting


* P&L management for Clinical Operations


* URAC/NCQA regulatory requirement


* Report abstraction and report generation for operational performance management


* People management


* Business Process Outsourcing


* Contract Negotiations


* Change Facilitation


* Process Excellence


* Clinical Operations


* Value Based Reimbursement


* Network & Provider Management


* Health Plan Clinical operations


* Worker?s Compensation


* Population Health Management


* Utilization Management.


* Deep experience working with Aging population

Role Expectation:


* Oversee clinical operations consisting of medical management, population health management to health plan, long term care insurers , ACOs and providers


* Be responsible for business outcomes against budget


* Provide direction and guidance to supervisory team overseeing day to day production and delivery of clinical services


* Provide mentorship for clinicians and support lifecycle management of clinical staff onshore


* Be responsible for performance against SLAs for all clinical programs delivered within the US geography


* Be responsible for execution of policies in compliance to URAC and NCQA standards and generating all relevant artefacts for Audits, participate in audits


* Support timely client implementation of new programs through timely hiring, training and ramp up of staff as per contracts and agreements.


* Be responsible for timely and routine business reviews with internal and client stakeholders.


* Support sales enablement as required


* Participate /collaborate in clinical strategy planning and execution, along with the clinical practice to grow and expand clinical services, capabilities and new offering


* Support new prospect and business development as needed, with timely pricing inputs, contract reviews and inputs for new opportunit...