Vice President, Healthcare Operations

About the Company

Mission-driven health insurance provider

Industry
Insurance

Type
Non Profit

Founded
1945

Employees
1001-5000

Specialties

• idaho health insurance
• idaho dental insurance
• idaho medicare advantage
• and idaho medicare advantage

About the Role

The Company is seeking a Vice President of Healthcare Operations to provide strategic leadership in clinical operations across various medical management domains. The successful candidate will be responsible for the design and implementation of business plans and technology solutions that align with the clinical strategy, with a focus on improving the efficiency and effectiveness of medical management operations. This role requires a minimum of ten years of experience in health plan managed care, particularly in utilization management and healthcare quality improvement, and a Bachelor's degree in a relevant field. A clinical designation with an unrestricted license, such as RN or higher, and a Master's degree in a related subject area, are preferred.Key responsibilities for the Vice President of Healthcare Operations include the development and distribution of performance and productivity reports, providing medical expertise in case and disease management, and partnering with various segments of the company to ensure the delivery of affordable and accessible healthcare benefits. The role also involves collaborating with go-to-market leaders, supporting the sales and marketing division, and participating in the development of departmental policies and procedures. The ideal candidate will have a strong background in healthcare and business processes, be adept at productivity measurement and monitoring, and possess excellent communication, leadership, and problem-solving skills. The ability to lead cross-functional teams, drive process improvements, and ensure programmatic excellence is essential for this position.

Hiring Manager Title
Chief Medical Officer

Travel Percent
Less than 10%

Functions

• Medical Care/Hospital Administration