Vice President – Clinical Operations

This is a fully remote position, open to applicants in Illinois.

📋 Description

• Serving as the primary clinical authority for leave and disability case management, ensuring precise claim determinations and effective return-to-work strategies.

• Offering specialized clinical consultation on intricate, high-risk, or escalated cases.

• Supervising clinical quality initiatives, including audits, peer reviews, nurse evaluations, and retrospective assessments to maintain consistency and best practices.

• Leading and facilitating routine clinical roundtable discussions to direct case strategies, functional capacity evaluations, and care planning.

• Managing and assessing physician consultants and senior clinical staff (RNs).

• Overseeing the recruitment, credentialing, performance management, and quality assurance of physician reviewers, IME providers, and peer review vendors.

• Evaluating peer review productivity, quality, and compensation for appropriateness.

• Conducting clinical credentialing meetings and ensuring compliance with licensure and certification standards.

• Creating and delivering ongoing clinical training for case managers, nurses, and physician consultants.

• Offering guidance and training for sensitive situations, including threats to self or others.

• Overseeing the creation of clinical content, including LOA guides, disability reference materials, attending physician forms, and onboarding curricula.

• Leading continuing medical education initiatives and external clinical lecture series.

• Supporting client relationship management by participating in quarterly and annual reviews.

• Providing clinical expertise during finalist meetings, RFPs, and sales presentations.

• Developing and presenting materials that clearly communicate the clinical model, peer review process, and value proposition.

• Conducting targeted clinical data analyses to assist clients in understanding trends, outcomes, and areas for improvement.

• Offering clinical insights into technology platforms, diagnostic coding, vendor integrations, and clinical thought design.

• Designing and reviewing reports, metrics, and analytics that demonstrate clinical outcomes, ROI, productivity, and quality.

⛳️ Requirements

• Hold an MD, DO, or an equivalent doctoral degree in a healthcare discipline.

• Maintain active clinical licensure and board certification.

• Have over 5 years of leadership experience in disability, leave, or absence management.

• Exhibit strong communication, presentation, and analytical skills.

• Possess extensive experience in clinical auditing, quality programs, and interdisciplinary team collaboration.

• Demonstrate a commitment to promoting diversity, collaboration, and a global perspective within clinical teams.

• Be recognized as a subject matter expert who has acted as a trusted advisor to senior leadership on clinical risk, strategy, and performance.

🏝️ Benefits

• Health, dental, and vision coverage starting on Day One.

• Wellbeing programs.

• Retirement plans with contribution matching.

• Generous time off policies.

• Parental leave.

• Continuing education opportunities.

• Career advancement potential.

• Flexible working arrangements.