VP, Clinical Operations

Position Title: Vice President, Clinical Operations

Reports To: SVP, Quality & Network Performance

Division: QP-MSO - QP-MSO

Department: 005240 - Clinical Administration

Classification: Exempt

Places of Work: Remote

People Leader: Yes

About the Organization:

Equality Health is an integrated, holistic, and tech-enabled healthcare delivery system focused on improving the health and wellness of diverse populations. Founded in 2015, Equality Health aims to improve access to value-based care for people who have long struggled with navigating the traditional one-size-fits-all U.S. healthcare system. The mission of the company is to provide high-quality care that improves and enhances lives regardless of race, ethnicity, age, or income.

Through its supplemental care management services and proprietary technology platform, CareEmpower™, Equality Health helps managed care plans and health systems improve outcomes and lower costs for diverse populations while simultaneously facilitating the transition to risk-based accountability. Equality Health supports over 800,000 members and more than 4,000 practice sites and continues to scale rapidly.

In 2021, Equality Health partnered with General Atlantic, a leading global growth equity firm, to help drive continued expansion and fuel the next phase of growth as a leading value-based primary care network serving the Medicaid, Medicare and ACA Exchange populations. This strategic investment will enable Equality Health to pursue further geographic expansion, technological innovation and product development while furthering its mission of increasing access to care, lowering costs and improving outcomes for underserved individuals, families and communities.

About the Role:

The Vice President, Clinical Operations is the senior clinical and operational leader for all direct member-facing clinical operations. This role unifies the operating model, performance accountability, and growth strategy for member-facing clinical teams, including Community Health Workers, pharmacy programs and pharmacy care support, and nurse practitioner (NPs) and NP support. The VP partners closely with the Chief Medical Officer and Medical Director to ensure clinically sound, member-centered, scalable care delivery that advances quality, access, engagement, and value-based outcomes across markets.

Key Responsibilities:

Strategic & Operational Leadership

• Provide strategic and operational leadership for all direct member-facing clinical operations, creating an integrated model that aligns Community Health Workers, pharmacy programs, care-support functions, and NP-enabled services around a consistent member experience.

• Develop and execute operating plans, policies, and processes that support safe, effective field-based, virtual, and community-based care delivery across existing and emerging markets.

• Partner with the Chief Medical Officer and Medical Director to translate clinical strategy into scalable operations.

Clinical Team Alignment & Member Access

• Provider day to day leadership oversight to Nurse Practitioners (NP) responsibilities related to workflows, capacity, access, and performance. NPs will have a solid line operational reporting relationship to the VP Clinical Ops, while maintaining a dotted line reporting relationship to the Medical Director for clinical oversight.

• Collaborate with Quality, Practice Performance, Care Coordination, Network, Analytics, and Technology teams to improve member engagement, care transitions, navigation, and clinical program design.

• Use data and frontline insight to identify opportunities to improve medication adherence, formulary adherence, care navigation, and access for Medicaid and Medicare populations.

Performance, Quality & Financial Accountability

• Establish, monitor, and act on key performance and leading indicators for quality, access, engagement, productivity, outcomes, member experience, and financial performance.

• Own operational performance against budget and resource plans; identify variances, remove barriers, and implement corrective action plans that support sustainable growth and operational excellence.

• Advance HEDIS/STAR and other quality outcomes in partnership with payer organizations, providers, and internal stakeholders; provide concise updates and recommendations to enterprise leadership.

Compliance, Risk & Care Delivery Standards

• Ensure operations comply with applicable licensure, credentialing, privacy, regulatory, certification-board, payer, and company requirements.

• Partner with Legal and Compliance to manage requirements for mobile and virtual care delivery and to strengthen operational controls.

Growth, Partnerships & Change Leadership

• Lead implementation and optimization of clinical operations in new markets, adapting service strategies to local member, provider, payer, and regulatory needs.

• Establish trusted, effective relationships with payer organizations, network providers, and internal stakeholders; clearly communicate complex clinical and operational information to diverse audiences.

• Champion process improvement, appropriate technology adoption, and disciplined change management to strengthen care delivery and the member experience.

People Leadership & Culture

• Build an accountable, inclusive, high-performing culture. Recruit, coach, develop, and retain operational leaders and team members.

• Ensure teams have the training, tools, equipment, and resources needed to deliver quality care and achieve measurable results.

Required Skills & Qualifications:

• Clinical licensure appropriate to discipline (for example, RN, NP, PharmD, or equivalent)

• A minimum of five (5) years of progressively responsible experience in healthcare operations, including leadership of direct member-facing clinical programs or services.

• Demonstrated clinical operations experience supporting multidisciplinary teams and clinically complex Medicaid and/or Medicare populations.

• Demonstrated understanding of the regulatory and operational requirements of value-based, managed-care, field-based, mobile, virtual, or community-based clinical programs.

• Track record of developing and scaling programs, managing budgets and performance metrics, and leading operational improvement in dynamic, high-growth environments.

• Strong analytical, problem-solving, written, verbal, and presentation skills, with the ability to synthesize complex data into clear actions and influence diverse stakeholders.

• Ability to gain credibility quickly, organize cross-functional teams, and translate strategy into practical, measurable execution.

• Proficiency with Microsoft Office applications and web-based technologies, including management and analysis of large bodies of data.

Preferred Skills & Qualifications:

• Formal training in process improvement, such as Lean or Six Sigma.

• Experience improving medication adherence, pharmacy quality programs, HEDIS/STAR performance, or other quality-measure outcomes.

• Experience working directly with payer organizations and provider networks in risk-based or managed-care arrangements.

• Commitment to culturally competent care, health equity, and building positive working relationships across a diverse organization.

Equality Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.