Vice President – Clinical Transformation

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Alignment Health

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Healthcare Insurance • Insurance • Healthcare

Alignment Health is dedicated to providing comprehensive care for Medicare members, emphasizing the needs of seniors, the chronically ill, and those who are frail. With a mission to transform senior healthcare, Alignment Health leverages a tailored care model and advanced technology to deliver high-quality, low-cost healthcare services. Their 24/7 concierge care team collaborates with trusted local providers to ensure that every member receives personalized care, reflecting the company's commitment to treating all members as valued family members.

501 - 1000 employees

Founded 2013

⚕️ Healthcare Insurance

💰 $135M Series C on 2020-03

📋 Description

• Develop and execute a comprehensive clinical transformation strategy that supports medical cost management, quality performance (e.g., STAR ratings, HEDIS, CAHPS), and member engagement goals. • Design, implement, and continuously refine evidence-based clinical programs and interventions targeting key disease states, utilization patterns, and population health priorities. • Collaborate with Regional Medical Directors, Operations, Pharmacy, Network, and Analytics teams to identify opportunities for clinical innovation and improvement. • Lead the translation of clinical insights into operationally executable programs that drive measurable outcomes. • Lead cross-functional initiatives integrating clinical operations, population health, risk adjustment, and quality improvement programs. • Oversee end-to-end lifecycle of clinical programs — from concept design through pilot, rollout, evaluation, and scaling. • Establish program KPIs and outcomes measurement frameworks; monitor performance and ensure continuous quality improvement.

🎯 Requirements

• 10+ years of progressive leadership experience in managed care, health plan operations, or population health management • Deep understanding of Medicare Advantage regulations, 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 to drive clinical and operational improvement. • Strong familiarity with utilization management, care management, and risk adjustment functions. • Master’s degree in Healthcare Administration, Public Health, or related field.

🏖️ Benefits

• Alignment Health is an Equal Opportunity/Affirmative Action Employer.