Senior Director, Clinical Alignment & Health Plan Partnerships

VNS Health; New York (NY); On-site; USD 173,000 - 231,000; Full time

Job summary

VNS Health is recruiting a senior leader to drive clinical alignment across Health Plans, Provider/Network teams and external partner organizations in New York. You will translate strategy into provider-facing programs, establish governance, and manage cross-functional initiatives to improve quality, utilization and member outcomes.

This executive role requires strong stakeholder engagement with hospitals, IPAs and health systems, plus deep knowledge of Medicare/Medicaid managed care in New

Qualifications

• Minimum 10 years of progressively responsible experience in managed care, health plan clinical operations, provider performance, population health, healthcare delivery or related environment.
• Experience at the intersection of a health plan and provider organizations leading complex cross-functional clinical initiatives.
• Experience engaging senior clinical and operational leaders within hospitals, health systems, physician organizations, IPAs or provider entities.
• Strong understanding of health plan clinical priorities including quality, utilization management, care management, population health and member outcomes.
• Ability to establish governance, drive accountability and influence outcomes across matrixed teams without direct authority.
• Experience using provider and clinical performance data to identify opportunities and drive improvement.
• Knowledge of Medicare and Medicaid managed care and the New York market strongly preferred

Responsibilities

• Develops and leads the Health Plans approach for aligning clinical priorities with Provider/Network strategies and external provider activities.
• Translates clinical strategy into coordinated provider-facing initiatives across quality, utilization, care management and member outcomes.
• Establishes governance, roles, escalation pathways and accountability for shared clinical priorities.
• Builds senior relationships with clinical and operational leaders across hospitals, health systems, IPAs and other partners in New York.
• Represents clinical priorities in strategic provider discussions and partners with Provider/Network leadership on quality and outcomes.
• Serves as escalation point for complex clinical issues involving strategic provider partners and mobilizes stakeholders.
• Partners with Clinical, Quality, Analytics and Provider/Network to coordinate provider performance measures.
• Identifies trends and opportunities and works with providers to implement improvement plans.
• Monitors progress and shares best practices across the Health Plans network.

Skills

Leadership

Stakeholder engagement

Cross-functional collaboration

Education

Bachelor's degree in Nursing / Healthcare Admin / Public Health / Business Admin

Master's degree in Healthcare Admin / Public Health / Business Admin / Nursing

Job description

VNS Health is recruiting a senior leader to drive clinical alignment across Health Plans, Provider/Network teams and external partner organizations in New York. You will translate strategy into provider-facing programs, establish governance, and manage cross-functional initiatives to improve quality, utilization and member outcomes.

This executive role requires strong stakeholder engagement with hospitals, IPAs and health systems, plus deep knowledge of Medicare/Medicaid managed care in New