Executive Lead, Clinical Services & Operations

Medical Mutual; Cleveland (OH); On-site; USD 250,000 - 350,000; Full time

Benefits offered by this job

On-site fitness centers

Gym membership reimbursement

On-site cafeteria

Employee discounts

Job summary

Medical Mutual is seeking a Vice President of Clinical Services & Operations to provide strategic leadership for Clinical Delivery teams, including Prior Authorization, Acute and Post-Acute Care, Case Management, and Medicare Clinical Services.

Reporting to the CMO, this leader will shape and execute high-impact clinical initiatives, manage executive communications, and collaborate with care delivery networks to achieve value-based outcomes and improve utilization, cost, quality, and member

Qualifications

• Bachelor’s degree in nursing required.
• Master’s degree in Business or Health Care Administration preferred.
• At least 10 years of progressive health care plan management experience in multiple clinical areas including government programs.

Responsibilities

• Directs cross-functional teams to plan, develop, evaluate, and implement division initiatives.
• Partner with VPs to advance clinical innovation and optimize strategies.
• Achieve medical management objectives for at risk patient populations.
• Coordinate division budget and prepare for CMO review and approval.
• Oversee clinical communications and materials across products.

Skills

Leadership

Strategic thinking

Communication

Clinical program knowledge

Education

Bachelor’s degree in nursing

Master’s degree in Business or Health Care Administration

10 years health care plan management experience

Tools

Microsoft Office

Database reporting

Clinical systems

Job description

Medical Mutual is seeking a Vice President of Clinical Services & Operations to provide strategic leadership for Clinical Delivery teams, including Prior Authorization, Acute and Post-Acute Care, Case Management, and Medicare Clinical Services.

Reporting to the CMO, this leader will shape and execute high-impact clinical initiatives, manage executive communications, and collaborate with care delivery networks to achieve value-based outcomes and improve utilization, cost, quality, and member