Vice President of Clinical Services

Job Description

The VP, Clinical Operations is responsible for collaboration, development, implementation and ongoing evaluation/optimization of programs and systems that enhance or improve outcomes within the Medical Management Care Management team consistent with best practices. Responsible for promoting high standards of clinical and operational excellence through defined policies and procedures as well as managing through disciplined metrics to ensure cost, quality, and member satisfaction objectives are met. Shares accountability for oversight, education, practice, and protocols in conjunction with the implementation of new standards of care. Develops effective, positive relationships across the organization in an interdisciplinary approach to lead, role model, collaborate, influence and effectuate change. Participates in initiatives that increase our market advantage and meet overall company strategic objectives.

Responsibilities

Develops, implements and operates an integrated, scalable, strategic and innovative portfolio of care, utilization and disease management programs using data and trend analysis aimed at improving health outcomes and member experience.

Identifies and establishes appropriate performance metrics to optimally manage operations, including staffing levels, productivity, and quality while maintaining a supportive, educational, patient-centric environment|Identifies cross-functional opportunities to improve outcomes and develops and implements administrative efficiency initiatives with measurable results.|Continuously assesses process effectiveness and efficiency to be a change agent in maximizing the quality of services while minimizing costs and increasing productivity. Applies broad knowledge and experience to situations/complex issues taking the initiative to analyze and recommend/implement appropriate action for continuous improvement.|Works proactively and collaboratively across the organization to ensure overall business objectives are met and supported. Attends various meetings and participates on committees as appropriate contributing ideas for improving efficiency, productivity, and member satisfaction.

Qualifications

Three years’ experience in a data analytics role and work experience in informationBachelors degreeMaster’s Degree or an equivalent combination of education and clinical operations experience is preferred.QI/PI methodology (CPHQ, CHCQM) or other related certifications within 1-3Registered Nurse Licensure