AVP, Clinical Operations

Job Summary

Provides strategy and leadership to a team responsible for enterprise clinical operations and program design initiatives. Supports and enables clinicians across Molina to drive desired member outcomes. Partners with executive leadership team to provide cohesive direction towards company goals. Contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

Supports strategy development, vision and direction for the health care services clinical operations function. Demonstrates accountability for performance and financial results, and keeps executive leadership apprised.

Leads a team of clinical professionals in one or both of the following capacities :

• Design and deployment of clinical health programs including organizing and managing enterprise-wide cross functional workgroups, programmatic content design, dashboard development, clinical and quality outcome metrics, and implementation.
• Design and development of programs and interventions to improve clinical operations across the enterprise, including clinical talent assessment, problem identification, and solutioning, developing remediation and / or improvement plans and recommendations to remove barriers, improve performance and assist clinical teams with setting priorities and identifying training needs.

May lead utilization management (UM), care management (CM) or other clinical functions within the organization.

Leverages relationships with internal partners to understand needs and respond with scorecards, tools, and processes.

Partners with clinical quality performance management leadership - fostering collaboration and knowledge sharing that aligns strategy and improves the member experience.

Leverages data analytics, area of expertise knowledge, and implementation skills.

Works effectively with clinical and operational stakeholders to synthesize information, develop and deploy measurement tools and oversee timelines, budgets, and return on investment (ROI) analysis.

Oversees all related meetings and committees, directs the data analysis and reporting, monitors performance and looks ahead to mitigate risks.

Actively supports implementations and serves as a resource to enterprise training and policy teams.

Oversees and navigates clinical technology and software applications.

Develops effective partnership and engagement strategies with applicable internal and external stakeholders and oversees pilot programs to test and deploy clinical initiatives across the Molina enterprise.

Contributes to Molina request for proposal (RFP) processes as requested.

Required Qualifications

At least 10 years experience in health care, preferably within clinical operations, or equivalent combination of relevant education and experience

At least 5 years of progressive people leadership experience to include experience fostering collaboration, teamwork, customer and quality centric focus and employee engagement.

Clinical licensure and / or certification may be required pertaining to clinical area of expertise.

Experience in utilization management (UM) / care management (CM) / behavioral health (BH) / long-term services and supports (LTSS) or other applicable health care related experience, as required for the specific functional area.

Experience with data analytics and implementing data driven programs and solutions.

Excellent verbal and written communication skills.

Microsoft Office suite / applicable software program(s) proficiency.

Preferred Qualifications

Clinical program design experience.