• Establish the business unit’s clinical strategic vision, objectives, policies and procedures to ensure delivery of cost effective services
• Monitor performance results against established metrics and benchmarks and recommend improvement opportunities
• Serve as the subject matter expert and participate in all new implementations
• Participate in customer, health plan, and QI meetings
• Oversee the production of reports required by management
• Collaborate with various departments to resolve operational issues
• Oversee annual budget for clinical operations
• Drive efforts to increase staff expertise at shaping clinical resources to perform more effectively in the delivery of care, including development of training programs

• Bachelor's degree in related field from a four-year college or university
• Minimum ten (10) years of clinical and operations experience in healthcare insurance industry
• Work related experience in the United States and understanding of the US Healthcare System (preferred)