VP Clinical Operations

Amerihealth Caritas•,

8d•Remote

About The Position

The Vice President of Clinical Operations provides strategy and leadership to optimize clinical operations across the enterprise, translating clinical strategy into a scalable, measurable, and cost-effective operating system. This role serves as the primary bridge between strategy and execution, ensuring clinical programs are standardized, compliant, and performance-driven across all markets. The VP establishes and implements processes to ensure clinical operations and vendor-delivered services meet state, federal, and regulatory requirements, while consistently achieving quality and compliance standards. In partnership with leadership, this role drives alignment to enterprise priorities and contributes to strategies that deliver high-quality, cost-effective member care. The VP is accountable for delivering measurable impact on medical cost trend, quality outcomes, operational efficiency, and growth, while strengthening vendor performance, advancing workforce capability through clinical systems training, and enabling differentiated clinical models for RFPs and new business.

Requirements

Bachelor’s Degree.
10 or more years of progressive leadership experience in clinical programs and operations.
Strong leadership, analytical, and communication skills, as well as a proven track record in clinical program management and operational strategy.
Access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required.

Nice To Haves

Master’s preferred in healthcare administration, nursing, or related field.
Business and/or Operations advanced education, training, or degree encouraged.

Responsibilities

Lead clinical program performance and ROI, delivering measurable impact on medical cost trend, quality outcomes, and administrative efficiency; establish KPIs aligned to HBR and affordability targets.
Own the enterprise clinical operating model, including workflows and policies & procedures, ensuring standardized, scalable, and compliant execution across markets.
Drive vendor strategy and performance, establishing outcome-based KPIs, measuring ROI, and guiding partnership decisions (including buy vs. build) to optimize value.
Embed performance management and analytics into operations, enabling data-driven decision-making and closed-loop accountability across clinical programs.
Champion workforce capability and clinical systems training, ensuring teams consistently execute standardized workflows and deliver high-quality, efficient care.
Oversee operational audit and continuous improvement, assessing adherence to workflows and performance standards and driving systemic process and efficiency enhancements.
Lead growth and RFP support, designing scalable, differentiated clinical models that strengthen competitive positioning and support market expansion.
Partner cross-functionally across the enterprise, ensuring alignment of strategy, execution, and organizational priorities.