Vice President, Clinical Engagement at quantum-health

Location:This position islocatedat our Dublin, OH campus with hybridflexibility.

Who we are

Founded in 1999 and headquartered in Central Ohio, we’re a privately-owned, independent healthcare navigation organization. We believe that no one should have to navigate the cost and complexity of healthcare alone, and we’re on a mission to make healthcare simpler and more effective for our millions of members. Our big-hearted, tech-savvy team fights to ensure that our members get the care they need, when they need it, at the most affordable cost – that’s why we call ourselves Healthcare Warriors®.

We’re committed to building diverse and inclusive teams – more than 2,000 of us and counting – so if you’re excited about this position, we encourage you to apply – even if your experience doesn’t match every requirement.

About the role

The Vice President (VP), Clinical Engagement is responsible for the design, execution and continuous improvement of Quantum Health’s clinical services and engagement model, ultimately driving value for our employer clients, their members, and our providers and partners. The VP, Clinical Engagementleads the performance of clinical services, including care management (care coordination, case management and disease management), utilization management, clinical specialty services, population health and lifestyle coaching programs, ensuring seamless program delivery, best-in-class member experience and exceptional whole person care focused clinical outcomes.

Uniting and leading the team around a shared vision, this servant leader will champion significant change initiatives and will develop and implement strategies that simplify and improve clinicaloutcomes, operational effectiveness and quality as Quantum Health continues its rapid growth. The leaderwill build and develop clinical teams through influence and inspirational leadership that advances the company’s inclusive and collaborative culture. This highly influential, strategic leadership role reports to the Chief Medical Officer.

What you’ll do (Essential Responsibilities)

Inspirational Leadership

• Build and develop strong clinical teams. Provide visionary leadership, advancing communication, collaboration, innovation, and continuous improvement across cross-functional teams to achieve organizational objectives.
• Foster a positive and inclusive environment that promotes professional growth, job satisfaction, and retention.
• Utilize a teamwork approach to build a culture of clinical excellence to achieve top performance of Quantum Health clinicians and support staff (nurses, social workers, therapists, lifestyle/health coaches, coordinators,etc.).

Clinical Program Design and Development

• Collaborate with cross-functional teams to develop innovative clinical programs aligned with member needs, employer objectives, and industry trends.
• Conduct comprehensive assessments and market research to identify opportunities for enhancement (e.g. health equity, community engagement, social determinants of health, etc.)
• Develop and refine clinical protocols, guidelines, and quality standards.
• Ensure adherence to regulatory and compliance requirements.

Clinical Program Delivery

• Oversee the end-to-end delivery of clinical programs, including implementation, management, auditing and evaluation.
• Build and lead a high-performing clinical operations team responsible for program execution.
• Develop and implement key performance indicators (KPIs) to measure program effectiveness, identify improvement opportunities, and ensure alignment with client performance guarantees/service level agreements (SLAs).
• Meet/exceed compliance standards with all applicable regulatory bodies, such as the Utilization Review Accreditation Commission (URAC), among others.

Clinical Operations Strategy

• Develop and execute the clinical operations strategy in alignment with the company's overall business objectives with a focus on scalability through 3-5x growth.
• Optimize clinical operations processes and workflows to improve efficiency and effectiveness.
• Identify and implement solutions to enhance clinical program delivery and data management.
• Manage and allocate clinical operations budget to maximize resource utilization.

Data Analysis and Insights

• Leverage data to measure outcomes, identify trends, and inform decision-making.
• Develop reporting and analytics capabilities to communicate performance to stakeholders.
• Identify opportunities to improve clinical program effectiveness based on data-driven insights.

Thought Leadership

• Provide clinical subject matter expertise as needed to a variety of non-clinical partners, including Sales, Client Engagement, Operations Leaders, Benefits Consultants, and Clients/Prospects.
• Present clinical content to various stakeholders, including executives, medical directors, board members/investors, and more.
• Build relationships with employer clients and their partners, gather feedback, and help design pathways to eliminate barriers to care and achieve optimal clinical quality and outcomes. All other duties as assigned.

What you’ll bring (Qualifications)

• Education: Bachelor’s degree required; Graduate degree preferred.
• Licensure: Active, unrestricted license in good standing to practice as a Registered Nurse (RN), Advanced Practice Registered Nurse (APRN), or Licensed Social Worker/Licensed Independent Social Worker (LSW/LISW) in your primary state(s) of residence required; multistate licensure preferred.
• Experience: 10+ years in healthcare operations leadership, ideally within benefits, navigation/care coordination, telehealth/virtual care, and/or managed care organizations.
• 5+ year of direct clinical practice/patient care experience
• 7+ years’ experience coaching and leading high-performing clinical teams; this includes coaching individual performance and managing through significant change.Demonstrated expertise in designing and implementing successful clinical programs.
• Proven experience leading collaborative, consensus-generating committees or workgroups with conviction and decisiveness.
• Expert knowledge of the healthcare industry, including payer, provider, and employer landscapes; Experience working with employer-sponsored health insurance plans preferred.
• Strong business acumen and analytical skills; ability to quickly aggregate and analyze information and arrive at data-informed decisions.
• Experience and comfort working across highly matrixed, complex organizations
• Excellent communication skills with the ability to build strong relationships with diverse stakeholders at all levels; Comfortable translating clinical concepts to non-clinical audiences.
• Strong administrative/technical skills; Comfort working on a PC using Microsoft Office (Outlook, Word, Excel, PowerPoint), IM/video conferencing (Teams & Zoom), and telephones efficiently.
• A high degree of personal accountability and trustworthiness, a commitment to working within Quantum Health’s policies, values and ethics, and to protecting the sensitive data entrusted to us.

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