Director of Integrated Clinical Service Operations

Operational Excellence & Value-Based Performance

• Operating Model Execution: Execute and manage the day-to-day service line operating model, including: overseeing schedule and capacity planning to ensure workforce productivity and load balancing, optimizing capacity utilization, and managing supply-demand

• Drive Population Health Metrics: Apply data analytics to perform root cause analysis, develop strategy, and execute interventions to hit key performance indicators (KPIs) and SLAs tied to HEDIS quality metrics, and total cost of care reduction, risk adjustment, and productivity

• Data & Dashboard Management: Partner with product, engineering, and data science teams to establish a performance management cadence, building and maintaining comprehensive dashboards to track service line KPIs / SLAs

Financial Accountability & Strategic Growth

• Optimize Unit Economics: Assist in managing the integrated clinical services budget, driving down the unit cost per engaged member by monitoring and improving the day-to-day operational efficiency of integrated clinical service teams

• Scale and Expand: Translate organizational growth plans into robust staffing models, implementation plans, and operational readiness protocols for new payer partners, provider networks, and markets 

• National Contracting & Reporting: Support executive presentation readiness and detailed performance reporting for health insurance contracts, contributing to the organization’s growing national footprint

Clinical Innovation & Care Model Excellence

• Design & Optimize Care Models: partner closely with clinical leadership to operationalize and implement cohesive, evidence-based behavioral health service models, specialized pharmacy protocols, and integrated nursing practices

• Standardize Workflows: Build scalable, standardized care delivery playbooks across pharmacy, behavioral health, and nursing to ensure safety, clinical excellence, and seamless coordination

• Documentation & Accuracy: Implement robust operational strategies to measure and support accurate, comprehensive clinical documentation to capture risk and reflect the true complexity of our population in our integrated clinical services programs

• Strategic Roadmapping: Translate broader company-wide strategic plans into comprehensive quarterly operational roadmaps, creating detailed task lists and execution plans for the teams

• Innovation & R&D: In partnership with clinical leadership, lead the operational execution of pilots, track performance metrics, and lead ROI / go-no go analyses

• Other duties as assigned

• You are excited to work in a startup environment, with the ambiguity and shifting priorities that might come with it at times

• You are willing to go the extra mile to exceed targets

• You are passionate about our mission to improve the lives and healthcare outcomes of marginalized communities

Required:

• Bachelor’s degree in Healthcare Administration, Business Administration, Operations Management, or a related field

• 3-5+ years of progressive leadership experience in clinical operations, healthcare delivery, or clinic management

• Proven track record of executing and managing day-to-day operating models, including capacity utilization, schedule planning, and balancing provider supply with patient demand

• Strong analytical proficiency with experience performing root cause analyses and utilizing data dashboards to monitor and improve service line KPIs and SLAs

• Experience building scalable, standardized clinical workflows or operational playbooks to ensure cross-team coordination and safety

• Experience with strategic project management with the ability to translate high-level company strategic plans into highly detailed, comprehensive quarterly operational roadmaps and actionable task lists for executing teams

• Experience monitoring departmental budgets, tracking unit economics (e.g., cost per engaged member), and translating organizational growth targets into practical staffing models

• Demonstrated experience utilizing scheduling, CRM, and EHR platforms alongside standard data tools (e.g., Excel or Google Sheets)

• Demonstrated ability to partner closely with clinical leaders to operationalize care models, while simultaneously collaborating with technical teams (product, engineering, data science) to build performance cadence

• Comfortable working on both high-level strategy as well as on-the-ground tactical problem-solving

Preferred:

• Master's degree (MHA, MBA, MPH, or MSN) 

• Direct experience managing clinical operations or population health initiatives within a value-based care (VBC) framework, with an operational understanding of HEDIS quality metrics, risk adjustment, and total cost of care

• Experience in managing behavioral health, pharmacy and/or nursing services

• Experience operating within a fast-paced, venture-backed, or tech-enabled healthcare startup environment (Series A or B)

• Experience leading Go-To-Market (GTM) expansion efforts, localized hiring surges, or health plan/payor implementation workflows

• Deep understanding of Medicaid, Medicare Advantage, Dual-Eligible populations, and the management of Social Determinants of Health (SDOH)