Vice President, Clinical Operations – AuthAI

🔥 0 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

⏰ Full Time

🔴 Lead

🏥 Clinical Operations

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Availity

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2000

⚕️ Healthcare Insurance

☁️ SaaS

🔌 API

💰 Secondary Market on 2021-07

Healthcare Insurance • SaaS • API

Availity is a leading health information network that connects payers, providers, and technology partners in the healthcare industry. By facilitating over 13 billion clinical, administrative, and financial transactions annually, Availity streamlines payer-provider collaboration and enhances patient care through an integrated provider engagement platform. The company's solutions leverage artificial intelligence and interoperability to automate processes such as prior authorizations, revenue cycle management, and payment accuracy, ultimately reducing costs and improving efficiency across the healthcare ecosystem.

📋 Description

• Lead strategy and execution behind AuthAI’s clinical delivery model • Help scale an innovative solution transforming utilization management • Oversee pre-sales scoping, timelines, and clinical resource planning • Ensure scalable, efficient, and compliant delivery commitments • Create strong clinical oversight models and clinical tooling • Lead policy mapping and ensure operational readiness for clinical content execution • Own DAG creation and ongoing policy updates with disciplined change control • Establish and run SLA auditing and review findings • Lead clinical audits and support coordinated improvement efforts across teams • Manage and resolve client escalations for clinical issues • Drive operational rigor across clinical QA and delivery processes • Provide sales support and deliver client education on AI and product process

🎯 Requirements

• Undergraduate degree in nursing, healthcare administration, business, or other relevant field • 3–4+ years of progressive leadership experience in a healthcare setting including change management • Prior relevant experience in healthcare or utilization management strongly preferred • Payer experience and understanding of health plan operations • Experience in leading teams through change and rapid growth • Advanced proficiency in Microsoft Office suite • Solid understanding of regulatory and compliance implications within UM workflows • Knowledge of industry standards around interoperability, UM platforms, EMR integrations, clinical data exchange standards • Excellent problem-solving, critical thinking, and attention to detail • Strong written and verbal communication skills, including ability to present to executives

🏖️ Benefits

• Competitive salary • Bonus structure • Generous HSA company contribution • Healthcare, vision, dental benefits • 401k match program from day one • Unlimited PTO for salaried associates + 9 paid holidays • 19 days of PTO starting for hourly associates • Gym membership reimbursement up to $250/year • Education reimbursement • Paid Parental Leave for both birth and adoptive parents • Community engagement opportunities