Executive Lead, Clinical Services & Operations

Superior Dental Care, Inc.; Cleveland (OH); Hybrid; USD 180,000 - 260,000; Full time

Benefits offered by this job

On-site fitness centers

On-site cafeteria

Employee bonus program

401(k) with company match

Health Savings Account

Parental leave

Job summary

Medical Mutual seeks a visionary leader to drive clinical delivery across Prior Authorization, Acute and Post-Acute Care, Case Management, and Medicare Clinical Services. Reporting to the CMO, this executive shapes clinical initiatives and communications to advance organizational priorities.

The role emphasizes collaboration with care networks, budget oversight, and strategic advisory duties to improve value-based outcomes and member satisfaction within a large Ohio-based health plan.

Qualifications

• Bachelor’s Degree in nursing or similar clinical area is required.
• Master’s degree in Business or Health Care Administration or related field preferred.
• 10 years progressive health care plan management experience in multiple areas of clinical care management (utilization, case, or disease) or quality, including government programs (Medicare, Medicaid).

Responsibilities

• Directs cross-functional teams through planning, development, evaluation, and implementation of Division initiatives.
• Partners with VPs and business owners to advance clinical innovation and optimize strategies.
• Achieves management objectives for all at-risk patient populations.
• Promotes cost-effective practice patterns through interventions with healthcare providers.
• Represents Clinical Operations as a subject matter expert in customer and broker presentations.

Skills

Verbal communication

Written communication

Leadership

Education

Bachelor’s Degree in nursing or similar clinical area of study

Master’s degree in Business or Health Care Administration or related field

Registered Nurse license (OH)

Tools

Microsoft Office

Database reporting

Clinical systems

Job description

Medical Mutual seeks a visionary leader to drive clinical delivery across Prior Authorization, Acute and Post-Acute Care, Case Management, and Medicare Clinical Services. Reporting to the CMO, this executive shapes clinical initiatives and communications to advance organizational priorities.

The role emphasizes collaboration with care networks, budget oversight, and strategic advisory duties to improve value-based outcomes and member satisfaction within a large Ohio-based health plan.