Vice President, Population Health – Clinical Operations

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

📋 Description

• Act as a primary stakeholder, decision maker, and catalyst for identifying, strategizing, evaluating, and monitoring market-level population health.

• Offer strategic leadership for population health both internally and in collaboration with providers, community organizations, advocacy groups, and relevant legislative bodies.

• Examine the local healthcare landscape to pinpoint drivers and opportunities for innovative Quadruple Aim models.

• Evaluate community health needs and population characteristics to create programs and services.

• Utilize analytics to uncover population insights and formulate targeted interventions.

• Supervise all market utilization management operations, encompassing prior authorization and concurrent review processes.

• Coordinate the population health strategy for the organization.

• Propel local HBR initiatives in collaboration with the Finance team.

• Collaborate with physicians to translate member needs into purposeful clinical program design and achieve successful health outcomes.

• Engage with state regulators regarding clinical programs.

• Manage quality initiatives, including audits, star ratings, and contract reviews, while implementing enterprise and local policies.

• Inform and execute contracts, including provider agreements, by driving outcomes and operationalizing them at the local level.

• Contribute actively to enterprise and local committees.

• Be an essential member of the executive leadership team, delivering clinical solutions to meet evolving business requirements.

• Implement standards and tailor them to local needs while partnering with Centers of Excellence to promote continuous improvement through governance and performance monitoring.

• Perform additional duties as assigned and adhere to all policies and standards.

⛳️ Requirements

• Bachelor's Degree is mandatory.

• A minimum of 5 years of relevant experience is required.

• A Master's Degree is preferred.

• A current state RN license is preferred.

• Capability to lead market-level population health strategy, evaluation, and monitoring.

• Experience with utilization management functions, including prior authorization and concurrent review.

• Proficiency in using analytics to derive population health insights and develop interventions.

• Familiarity with healthcare markets, community health needs, clinical program design, quality initiatives, and contract operationalization.

• Ability to collaborate with physicians, providers, Finance, regulators, community organizations, advocacy groups, committees, and executive leadership.

• Competence in executing standards, customizing local requirements, and driving governance and performance monitoring.

🏝️ Benefits

• Competitive compensation.

• Health insurance coverage.

• 401K retirement plan.

• Stock purchase plans available.

• Tuition reimbursement offered.

• Paid time off in addition to holidays.

• Flexible work arrangements including remote, hybrid, field, or office schedules.

• Additional forms of incentives may be included in total compensation.