VP of Clinical Operations - Value-Based Care

E2E Alignment Healthcare USA, LLC; Georgia; Hybrid; USD 228.000 - 342.000; Vollzeit

Zusammenfassung

Alignment Health is seeking a VP of Clinical Operations to lead strategic development, design, and continuous improvement of clinical programs across value-based care. You will oversee holistic patient management and optimize transitions of care to improve member outcomes and manage costs.

The role requires 5+ years of senior leadership in care management or clinical operations, with deep knowledge of Medicare Advantage and quality metrics, and a proven track record of scalable programs.

Qualifikationen

• 5+ years in care management or clinical operations with at-risk contracts.
• Deep understanding of Medicare Advantage, Transitional Care Management (TCM), STARS and HEDIS metrics.
• Proven track record of developing and implementing scalable clinical programs.
• Experience leveraging analytics and embedding care management modules in EHR systems.
• Deep understanding of utilization management, care management, and risk adjustment functions.

Aufgaben

• Develop and lead a comprehensive clinical strategy to support medical cost management, quality performance, and member engagement goals.
• Design end-to-end transitional care management programs for high-risk patients before hospitalization and safe transitions.
• Refine evidence-based clinical protocols for chronic disease management, predictive risk-stratification, and SDOH tracking.
• Lead cross-functional initiatives across clinical operations, population health, risk adjustment, and quality improvement.
• Evaluate emerging technologies—AI-driven triage, decision support, remote monitoring, and telehealth—to improve outcomes.
• Collaborate with providers and care teams to ensure timely communication and achieve outcomes.
• Oversee lifecycle of clinical programs from concept through pilot, rollout, evaluation, and scaling.

Kenntnisse

Strategic thinking

Execution discipline

Leadership

Analytical mindset

Communication

Collaboration

Ausbildung

Master’s degree in Healthcare Administration, Nursing, Public Health, or related field

Active licensure as RN, NP, PA, MD/DO

Jobbeschreibung

Alignment Health is seeking a VP of Clinical Operations to lead strategic development, design, and continuous improvement of clinical programs across value-based care. You will oversee holistic patient management and optimize transitions of care to improve member outcomes and manage costs.

The role requires 5+ years of senior leadership in care management or clinical operations, with deep knowledge of Medicare Advantage and quality metrics, and a proven track record of scalable programs.