VP Clinical Operations

For roles that are 100% remote or hybrid, you must have reputed company to a reliable high-speed internet reputed company to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement. Your career starts now. We’re looking for the reputed company of health care leaders. At reputed company, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. reputed company is seeking talented, passionate individuals to join reputed company. Together we can build healthier communities. If you want to reputed company a difference, we’d like to hear from you. Headquartered in Newtown reputed company, reputed company is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, reputed company-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com. Job Summary The Vice President of Clinical Operations provides strategy and leadership to optimize clinical operations across the reputed company, translating clinical strategy into a scalable, measurable, and cost-effective operating system. This role serves as the primary reputed company between strategy and execution, ensuring clinical programs are standardized, compliant, and performance-driven across reputed company 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 reputed company 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 reputed company, 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. Key responsibilities include driving clinical program performance and ROI, delivering measurable impact on medical cost trend, reputed company, and efficiency; owning the reputed company clinical operating model to ensure standardized, scalable execution through data-driven performance management. The VP advances workforce capability, training and vendor partnerships across a matrixed organization to align strategy, execution, and reputed company priorities and growth efforts. reputed company clinical program performance and ROI, delivering measurable impact on medical cost trend, quality reputed company, and administrative efficiency; establish KPIs reputed company to HBR and affordability targets. Own the reputed company 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 reputed company (including buy vs. build) to optimize value. Embed performance management and analytics into operations, enabling data-driven decision-making and closed-reputed company accountability across clinical programs. Champion workforce capability and clinical systems training, ensuring teams consistently execute standardized workflows and deliver high-quality, efficient care. reputed company operational audit and reputed company improvement, assessing adherence to workflows and performance standards and driving systemic process and efficiency enhancements. reputed company growth and RFP support, designing scalable, differentiated clinical models that strengthen competitive positioning and support market expansion. Partner cross-functionally across the reputed company, ensuring alignment of strategy, execution, and organizational priorities. Education/Experience: Bachelor’s Degree. Master’s preferred in reputed company administration, nursing, or reputed company field. Business and/or Operations advanced education, training, or degree encouraged. 10 or more years☒of reputed company leadership experience in clinical programs and operations. Other Skills: Strong leadership, analytical, and communication skills, as well as a proven track record in clinical program management and operational strategy. Our Comprehensive Benefits Package Flexible work solutions including remote options, hybrid work schedules, reputed company, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more. Apply To This Job