Clinical Operations Manager - Virtual Care Management (RN)

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Clinical Operations Manager - Virtual Care Management (RN) based in United States.

This role leads virtual care operations that support patients between clinical visits, including care navigation, longitudinal chronic care management, and remote therapeutic monitoring.
You will manage these functions through a team of supervisors, ensuring patients receive timely follow-up, appropriate clinical support, and consistent care coordination.
The position combines clinical credibility with operational leadership across multiple teams, workflows, queues, and coverage models.
You will oversee performance, staffing, quality, compliance, and service delivery while translating operational data into practical workflow decisions.
A key focus is ensuring strong follow-through, from test results and provider orders to chronic condition outreach, documentation, and escalation.
You will also help develop scalable processes, support program growth, and maintain effective 24/7 coverage across a remote workforce.
This is a fully remote U.S.-based leadership opportunity for an experienced RN who is highly organized, data-driven, and comfortable operating in a fast-paced virtual healthcare environment.

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Accountabilities:

• Lead daily care navigation operations, including case assignment, prioritization, aging, closure, and accountability for patient cases from initiation through resolution.
• Establish and enforce workflow standards for time-sensitive activities such as returned results, clinical rechecks, provider order follow-up, returned faxes, and referrals.
• Set production expectations, caseload capacity, and turnaround-time standards by task type while monitoring queue health and reallocating work before backlogs develop.
• Define clear responsibilities and escalation pathways across RNs, care navigation specialists, clinical leads, and supervisors.
• Oversee longitudinal chronic care management operations, including care plan development, patient outreach cadence, and documentation completeness.
• Manage daily execution of 24/7 nursing coverage, including shift handoffs, overnight production expectations, weekend and holiday rotations, and minimum staffing requirements.
• Ensure inbound patient calls are answered and clinically triaged appropriately across all operating hours, including rollover coverage from adjacent teams.
• Partner with clinical leadership on scope-of-practice requirements, triage protocols, and escalation processes involving providers.
• Lead remote therapeutic monitoring operations through medical assistants and licensed practical nurses conducting proactive outreach, medication adherence monitoring, and interventions.
• Manage ratio-based caseload models, assigning and rebalancing patient panels as census changes and escalating staffing needs when growth exceeds workforce plans.
• Ensure clinical concerns are promptly escalated to nursing and provider teams while maintaining required documentation and billing standards for monitoring services.
• Execute published staffing plans across caseload-based, coverage-based, and 24/7 operating models, making real-time staffing decisions when circumstances change.
• Manage schedule adherence, shift swaps, same-day absences, and planned overtime while escalating structural coverage needs to workforce operations.
• Participate in interviewing, selection, and onboarding while identifying staffing gaps early enough to support timely hiring.
• Build and maintain operational reporting covering throughput, case aging, schedule adherence, census, and quality, using the data to drive workflow decisions.
• Coach and develop supervisors and clinical leads in performance management, documentation, accountability, and team leadership.
• Partner with quality and compliance teams to meet clinical, HIPAA, and health plan contractual requirements, including audits and gap-closure activities.
• Contribute to workflow design, SOP development, testing, training, and operational implementation as programs, health plan partnerships, and platform capabilities evolve.
• Lead, develop, and hold supervisors accountable while building bench strength and maintaining clear role boundaries between leads and supervisors.
• Monitor team turnover and actively address retention through onboarding, workload management, scheduling practices, career development, and frontline leadership quality.
• Promote employee satisfaction, engagement, connection, visibility, and recognition across remote teams.

Requirements

• Active, unrestricted RN license with direct patient care experience; multi-state or compact licensure is preferred.
• Experience in a virtual care practice or healthcare contact center environment, including telehealth, care management, disease management, population health, or similar operations.
• At least 3 years of people leadership experience, including management of supervisors or team leads in a clinical or production operations setting.
• Demonstrated ability to manage multiple concurrent workflows involving distinct teams, queues, programs, deadlines, and operating requirements.
• Experience managing caseload- or panel-based work while holding teams accountable for throughput and turnaround-time standards.
• Experience managing coverage, schedule adherence, and real-time staffing decisions against established staffing plans.
• Demonstrated success with employee retention and reducing attrition, ideally within a remote or high-volume healthcare environment.
• Strong data fluency, including the ability to build and interpret operational reports, Excel analyses, and dashboards and translate findings into action.
• Proficiency with EHR and practice management systems, telehealth platforms, care management documentation tools, and CRM systems.
• Strong understanding of HIPAA, patient privacy, and healthcare compliance obligations in a remote environment.
• Availability to support 24/7 operations, including rotating weekend and holiday escalation coverage.
• Bachelor of Science in Nursing, or a bachelor’s degree in healthcare administration, business, or a related discipline, preferred.
• Direct experience with CCM, APCM, RPM, or RTM program operations, including documentation and billing requirements, preferred.
• Experience supporting Medicare Advantage, Medicare Part D, or delegated health plan programs, including quality measures and gap closure initiatives such as HEDIS, Star Ratings, or SUPD, preferred.
• Experience developing or restructuring 24/7 coverage models is beneficial.
• Experience in a high-growth or rapidly scaling healthcare organization is preferred.
• Strong follow-through and accountability, with a focus on ensuring work is fully completed and documented.
• Ability to manage several unrelated workstreams simultaneously without losing focus on deadlines or outcomes.
• Ability to communicate credibly with clinical teams while also operating effectively with senior and executive stakeholders.
• Highly self-directed, organized, and effective in a remote environment.
• Strong inclination toward documenting, standardizing, and simplifying manual or informal processes.
• Must be able to perform all work physically within the United States; international work during scheduled work hours is not permitted.

Benefits

• Fully remote position within the United States.
• Full-time, exempt employment.
• Leadership opportunity overseeing supervisors and multiple virtual care operations.
• Opportunity to shape care navigation, chronic care management, remote therapeutic monitoring, and 24/7 clinical operations.
• Exposure to clinical operations, workforce management, quality, compliance, and healthcare program development.
• Opportunity to contribute to process improvement, SOP development, training, and scalable operational models.
• Home-office environment with flexibility inherent to remote work.
• Secure, private workspace and reliable high-speed internet required.
• Computer equipment must be a Windows or Apple macOS device; Chromebooks, Linux machines, and smartphones are not permitted for work.
• Minimum computer requirements include Windows 10 or later or macOS 14 Sonoma or later, Intel Core i5/AMD equivalent or Apple Silicon, and 16 GB RAM.
• Wired headphones with an external or dedicated microphone are required.
• Minimum internet requirements of 100 Mbps download and 50 Mbps upload, with a direct Ethernet connection from the computer to the router.
• Google Chrome and Amazon Workspaces are required.
• Webcam required for video calls; built-in laptop webcams are acceptable.
• A second monitor is strongly recommended for laptop users, with dual monitors suggested for PC users.

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How Jobgether works:

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

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