Vp Jobs

About The Position

Requirements

• 15+ years of experience in healthcare industry
• 7+ years Managed Care experience in an operations environment
• 5+ years experience in managing a large/cross functional end-to-end product teams
• 5+ years managing budget and capacity models

Nice To Haves

• Experience leading programs tied to clinical outcomes in value based models
• Formal business process/management engineering training

Responsibilities

• Develop and execute strategic plans to transform traditional UM to care orchestration between health plan coverage, provider networks and members. Directly drive execution for scalability, workflow efficiency and member experience leveraging tech and automated solutions.
• Drive the development of new health solutions products in partnership with plan design, affordability and growth; leverage direct member marketing and engagement.
• Align Clinical Operations functions with overall strategic goals, particularly in areas of trend management, quality improvement and member satisfaction; drive collaboration across departments to ensure integrated service delivery.
• Orchestrate the execution of high-priority, cross-functional initiatives that bridge the gap between clinical strategy and execution. Apply rigorous program management discipline to ensure that complex Clinical projects are delivered on time, aligned with enterprise KPIs, and supported by the necessary change management to drive long-term organizational adoption.
• Analyze operational data to identify trends, risks and opportunities for improvement; spearhead the development of a framework that translates real-time performance data into actionable insights; leverage these analytics to refine clinical policies, optimize care pathways, and empower providers with the point-of-care tools necessary to drive superior health outcomes and medical trend management.
• Monitor external market trends, emerging care technologies, regulatory shifts and population health trends to inform multi-year business planning; translate these external signals—along with internal performance data—into actionable strategies that evolve our clinical operating model, ensuring the organization remains a leader in care delivery.
• Partner with Technology organization and Clinical leadership to identify and deliver new systems, tools and capabilities, prioritize technology initiatives across the Clinical organization, and oversee implementation of solutions to achieve business objectives.
• Lead clinical governance model to promote alignment and collaboration; establish the right key performance indicators, regularly monitor and report on progress to executive leadership team (including Clinical Quarterly Business reviews).
• Manage and mentor a team while fostering a culture of collaboration, innovation and accountability.
• Monitor financial performance and implement cost saving measures without compromising quality or member experience.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Benefits

• medical
• dental
• vision benefits
• 11 paid holidays
• paid sick time
• paid parental leave
• 401(k) plan participation
• life and disability insurance
• paid wellness time and reimbursements
• unlimited vacation program
• company equity grants
• annual performance bonuses