- 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)
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