Clinical Workforce Manager

Location: Remote (For Non-Local) or Hybrid (Local to NYC area)

About the Role:

We are seeking for a Clinical Workforce Manager to develop a workforce management program for our Prior Authorization and Clinical Call Center teams. You'll be responsible for creating and managing workforce strategies that align with our operational goals, ensuring we have the right people in place at the right time, and managing our strategic partnerships. Key responsibilities will include planning, scheduling, forecasting, and budgeting to optimize staffing to ensure exceptional service As part of this role, you'll manage real-time workforce efforts, drive staffing optimization, and provide insights that help shape operational decisions. For this evolving and dynamic role, we're looking for someone who is creative in their approach to problem-solving, innovative, adaptable, and ready to shape a brand-new function and grow with us.

Position Responsibilities:

• 
  

  Collaborate with Prior Authorization and Clinical Care Management to develop actionable strategies to optimize staffing levels, drive exceptional customer service and ensure operational efficiency within the department.

  
  

• 
  

  Oversee the daily, real-time performance of agents handling prior authorization requests and clinical calls, ensuring efficient queue management and optimal resource allocation to meet demand and regulatory requirements.

  
  

• 
  

  Manage attendance reporting for agents on a daily, weekly, and monthly basis, ensuring accurate time tracking and shift adherence.

  
  

• 
  

  Address scheduling adjustments, overtime, and undertime requests in a timely manner.

  
  

• 
  

  Ensure agents are assigned to appropriate skill sets, utilizing reports to track performance and adjust assignments as needed.

  
  

• 
  

  Ensure the accuracy of workforce management and payroll data including the creation and maintenance of performance reports reflecting key metrics such as service levels, call volume, agent productivity, and adherence to staffing schedules.

  
  

• 
  

  Leverage data analytics to monitor workforce performance, identify trends, provide insights on staffing requirements, advising on hiring needs and workforce decisions based on forecasts, historical data, and real-time performance metrics.

  
  

• 
  

  Act as the primary point of contact for system-related issues impacting production, collaborating with IT and other relevant teams to resolve any challenges.

  
  

• 
  

  Partner with training departments to schedule training sessions for agents, ensuring minimal disruption to service levels while maintaining appropriate coverage during training hours.

  
  

• 
  

  Prepare and deliver reports on workforce metrics, performance, and strategic initiatives to leadership.

  
  

• 
  

  Research industry standards and benchmark against other call centers and prior authorization departments to stay informed on best practices in service levels, technology usage, and call routing processes.

  
  

• 
  

  Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.?

  
  

Skills and Competencies:

• 
  

  Proven ability to create and execute strategic workforce plans that align with business goals and adapt to changing needs.

  
  

• 
  

  Skilled in forecasting staffing needs and using workforce data to make impactful, data-driven decisions, including data analytic skills

  
  

• 
  

  Experience with workforce management tools and analytics to enhance performance and operational outcomes.

  
  

• 
  

  Strong leadership and mentoring skills to develop and manage a high-performing team.

  
  

• 
  

  Exceptional communication skills to present complex strategies in a clear, accessible way to all stakeholders.

  
  

• 
  

  Creative problem-solving and critical thinking to tackle workforce challenges with innovative solutions.

  
  

• 
  

  Ability to make informed decisions under pressure, adapting strategies as needed in a fast-paced environment.

  
  

• 
  

  Strong project management skills, successfully balancing multiple priorities and driving initiatives from start to finish.

  
  

Experience and Qualifications:

• 
  

  3+ years of experience in a workforce management role.

  
  
• 
  

  Prior authorization experience at a PBM strongly preferred.

  
  
• 
  

  A bachelor's degree in business management, math, statistics, economics, or a related field is preferred but not required; equivalent training and experience may be substituted and considered.

  
  
• 
  

  Experience leading and participating in process improvement projects, preferably with Lean/Six Sigma certifications (Green/Black belt).

  
  

• 
  

  Strong knowledge of workforce management principles, practices, and tools.

  
  

• 
  

  Experience with Microsoft Excel utilizing formulas, V-Lookups, and pivot tables, required

  
  

• 
  

  Proficiency in workforce management software and data analytics (UKG, Five9, NICE inContact CXone, IEX, Genesys, Intradiem, and/or Verint).

  
  

• 
  

  Ability to utilize features such as Intraday Grid, Intraday Reforecasting, Real-Time Adherence, and proactive notifications & alerts.

  
  

• 
  

  Previous vendor management experience, preferred.

  
  

• 
  

  Excellent analytical, problem-solving, and decision-making skills.

  
  

• 
  

  Flexibility to respond to unexpected challenges and opportunities.

  
  

• 
  

  Strong leadership and management abilities.

  
  

• 
  

  Excellent communication and interpersonal skills to build and maintain relationships with internal and external stakeholders.

  
  

• 
  

  High level of attention to detail to ensure accuracy in workforce planning and scheduling. Ability to identify and address discrepancies in workforce data.

  
  

• 
  

  Ability to work effectively in a fast-paced, dynamic environment.

  
  

• 
  

  Ability to work a full-time schedule, including varied hours/days, including nights, weekends, and holidays as needed.

  
  

Base Salary: $90k - $105k

Visa Sponsorship: Capital Rx does not provide sponsorship to any candidates. This includes, but is not limited to those that require H1-B, TN, OPT, etc. Candidates must have authorization to work in the US at the time of application and throughout employment.

This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

About Capital Rx

Capital Rx is a health technology company providing claim administration and technology solutions for carriers, health plans, TPAs, employer groups, and government entities. As a public benefit corporation, Capital Rx is executing its mission to materially reduce healthcare costs as a full-service PBM and through the deployment of Judi, the company's cloud-native enterprise health platform. Judi connects every aspect of the healthcare ecosystem in one efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of benefits and rebuilding trust in healthcare.

Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.