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Vice President of Clinical Operations

Job Attributes

Job Id:

25437

Job Category:

Clinical & Life Sciences

Job Location:

Linthicum Heights, MD  21090

Security Clearance:

No Clearance

Business Unit:

Piper Companies

JOB DESCRIPTION

Piper Clinical Solutions is seeking a motivated Vice President of Clinical Operations to join a new area of growth for an established Health Insurance and Medical Solutions Organization in Anne Arundel County, MD.  The Vice President of Clinical Operations will develop, oversee, and drive business development, budget management, and roll-out of a clinical operations compliance model for all lines of business.

 

Responsibilities for the Vice President of Clinical Operations

  • Lead the migration to a new Clinical Operations compliance model for all Clinical Products and Client Services related to end-to-end management of healthcare insurance (benefit review, utilization management, cost of care, outreach programs)
  • Assist with NCQA filing and ensure all operational processes are compliant with NCQA regulations in support of accreditation filing in 2019
  • Oversight of Clinical Operations program to ensure achievement of financial and growth goals
  • Lead the development of an implementation framework for the Clinical Operations program that clearly outlines the clinical operations program features and performance guarantees
  • Lead enterprise-wide integration of clinical operations division to ensure an impactful formulation of a high functioning team that meets client needs and drives high performance in all programs
  • Development of KPI’s, reporting metrics, analytics, and internal SLA’s to drive measurable results tracking with program roll-out
  • Development and ongoing management of the future state of the Clinical Operations processes and technology through new vendor
  • Responsible for the creation of a compliance model for individual operation units through a formalized quality and audit program supporting real-time, concurrent compliance
  • Develop and maintain staffing models for Clinical Operations business
  • Oversee all IT projects and software selection related to compliance development and future modifications
  • Coordinate and communicate activities between Clinical Programs related to compliance report requirements to maintain operational efficiency and standards
  • Collaborate with other departments to troubleshoot, problem solve, and exchange information to effectively communicate with providers and members 

 

Requirements for the Vice President of Clinical Operations:

  • 10+ years of healthcare insurance compliance experience
  • 8+ years of healthcare management experience
  • Thorough knowledge of healthcare delivery systems, including budgetary accountability, compliance, and workforce management

Compensation for the Vice President of Clinical Operations

  • Salary up to $180,000 based on experience
  • Full Benefits: Health, Dental, Vision Insurance, 401K, PTO, Paid Holidays

 

Please send all qualified resumes to: idusci@pipercompanies.com

 

Keywords:

NCQA, Compliance, healthcare, health, clinical, utilization review, case management, risk contracting, quality incentives, pay for performance, clinical data, financial analysis, Utilization Management Organization, tracking sampling, trend analysis, compliance modeling, clinical operations, KPI, SLA, benefit review, utilization management, cost of care, outreach programs, Vice president, clin ops, vp, healthcare insurance, vision, health insurance

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Job Id:

25437

Job Category:

Clinical & Life Sciences

Job Location:

Linthicum Heights, MD  21090

Security Clearance:

No Clearance

Business Unit:

Piper Companies