VP, Clinical Operations

Alignment Health

. Develop and execute a comprehensive clinical strategy supporting medical cost management, quality performance, and member engagement goals .

Posted 10/23/2026full-timeRemote • United StatesLead💰 $227,952 - $341,928 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in developing and executing clinical strategies that enhance quality performance and member engagement while managing costs. Proficient in leading cross-functional initiatives and implementing evidence-based protocols for chronic disease management and transitional care.

Highest-signal resume keywords

Clinical Strategy DevelopmentPopulation Health ManagementTransitional Care ManagementMedicare Advantage RegulationsData Analytics and Technology Integration

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Chronic Disease ManagementPredictive Risk StratificationQuality ImprovementUtilization ManagementRisk AdjustmentClinical Program DevelopmentKPI EstablishmentProcess Improvement MethodologiesEHR Systems IntegrationTelehealth Technologies

Soft Skills

LeadershipCollaborationCommunicationStrategic ThinkingProblem Solving

Tools & Technologies

AI-Driven TriageClinical Decision SupportRemote MonitoringTelehealth PlatformsClinical Analytics

Certifications & Qualifications

Master's Degree in Healthcare AdministrationMaster's Degree in NursingMaster's Degree in Public Health

Industry Keywords

Value-Based CareACO ContractsHEDIS MetricsCMS ComplianceStars Ratings

About the role

Key responsibilities & impact

Develop and execute a comprehensive clinical strategy supporting medical cost management, quality performance, and member engagement goals
Design end-to-end transitional care management programs for high-risk patients before hospitalization and transitions to appropriate care settings
Design, implement, and refine evidence-based protocols and interventions for chronic disease management, predictive risk stratification, and SDOH tracking
Lead cross-functional initiatives integrating clinical operations, population health, risk adjustment, and quality improvement
Evaluate and recommend AI-driven triage, clinical decision support, remote monitoring, and telehealth technologies
Collaborate with primary care providers and hospitalists to ensure timely communication and feedback
Oversee clinical programs from concept design through pilot, rollout, evaluation, and scaling
Establish KPIs and outcomes measurement frameworks; monitor performance and continuous quality improvement
Integrate clinical analytics and predictive modeling to identify intervention opportunities and measure ROI
Ensure alignment with CMS, HEDIS, CAHPS, HOS, Stars, and risk adjustment requirements
Partner with provider networks and care management teams to enhance coordination and reduce avoidable utilization
Ensure consistent execution of the clinical operating model across regions
Lead a large geographically distributed team of clinicians, managers, and support staff
Develop leaders in operational performance management, problem solving, and talent development
Establish vendor expectations and metrics, monitor outcomes, and hold vendors accountable
Develop standardized processes, workflows, and toolkits for clinical intervention delivery
Implement process improvement methodologies and optimize resource utilization
Drive adoption of technology and data solutions for precision targeting, automation, and real-time insights
Manage accountability for programs, productivity, cost control, revenue growth, budgets, variances, and capital expenditure planning
Advise executive leadership on population health, value-based care, and clinical innovation
Build relationships with providers, vendors, and community partners
Oversee staff recruiting, selection, orientation, training, workload assignment, performance appraisal, coaching, counseling, and performance management

Requirements

What you’ll need

5+ years of progressive leadership experience in care management, population health, or clinical operations, with a proven track record of managing operations under at-risk, ACO, or capitated payer contracts
Deep understanding of Medicare Advantage regulations, Transitional Care Management (TCM), STARS and HEDIS metrics, and value-based care models
Proven track record of developing and implementing scalable clinical programs that improve outcomes and reduce total cost of care
Experience leveraging analytics and technology and embedding care management modules inside EHR systems
Deep understanding of utilization management, care management, and risk adjustment functions
Master’s degree (or higher) in Healthcare Administration, Nursing, Public Health, or related field
Strategic thinker with strong execution discipline
Excellent leadership, influence, and collaboration skills across cross-functional teams
Strong analytical mindset and comfort interpreting clinical and financial data
Exceptional communication and presentation abilities
Demonstrated commitment to innovation, member-centric care, and continuous improvement