Vice President Clinical Operations

Title: VP of Clinical OperationsLocation: Hybrid (NYC Metropolitan Area)Base Salary: $200,000 - $250,000Job Summary:The VP Clinical Officer will lead the Health plans clinical programs, focusing on health plan operations, NCQA accreditation, and HEDIS measures. This role involves managing a team of RNs, driving patient care strategies, and ensuring compliance with regulatory standards to improve member outcomes and clinical efficiency.Key Responsibilities:Clinical Leadership: Develop and manage clinical programs that align with health plan goals, improve HEDIS measures, and ensure NCQA compliance. Lead a team of RNs, ensuring best practices and regulatory adherence.Operational Management: Oversee clinical operations, collaborate with cross-functional teams, and optimize resources. Develop population health, case management, and utilization management programs.Quality & Compliance: Lead HEDIS program development and quality assurance efforts. Ensure compliance with federal, state, and NCQA standards for health plan accreditation.Stakeholder Engagement: Communicate with stakeholders, including clinical staff, board members, and regulatory agencies. Represent the health plan in external forums.Staff Development: Mentor and support the professional growth of clinical staff, particularly RNs, and ensure ongoing education and training.Skills:Strong leadership in clinical operations within a health plan.Deep knowledge of NCQA standards, HEDIS measures, and healthcare regulations.Excellent communication and team management skills.Qualifications:Bachelor of Science in Nursing (BSN) required; MSN preferred.10+ years leading clinical operations in a health plan or complex healthcare organization, with experience in NCQA accreditation and HEDIS performance.Proven experience managing and developing RN teams.

Created: 2025-02-22