Vice President, Clinical Operations--AuthAI (Remote)

Availity delivers revenue cycle and related business solutions for health care professionals who want to build healthy, thriving organizations. Availity has the powerful tools, actionable insights and expansive network reach that medical businesses need to get an edge in an industry constantly redefined by change.

At Availity, we're not just another Healthcare Technology company; we're pioneers reshaping the future of healthcare! With our headquarters in vibrant Jacksonville, FL, and an exciting office in Bangalore, India, along with an exceptional remote workforce across the United States, we're a global team united by a powerful mission.

We're on a mission to bring the focus back to what truly matters – patient care. As the leading healthcare engagement platform, we're the heartbeat of an industry that impacts millions. With over 2 million providers connected to health plans, and processing over 12 billion transactions annually, our influence is continually expanding.

This is a rare chance to build something meaningful at the intersection of healthcare, AI, and operations. As the Vice President, Clinical Operations, Auth AI you will lead the strategy and execution behind AuthAI’s clinical delivery model, helping scale an innovative solution that is transforming utilization management. If you thrive in high-impact roles, love building from the ground up, and want to shape the future of AI-enabled healthcare, this is the opportunity to do it.

Sponsorship, in any form, is not available for this position.

Location: Remote, US
 

Why you want to work on this team:

• Passionate about building and leading a high-impact clinical operations function at the intersection of healthcare, AI, and innovation.
• Enjoy shaping strategy across the business by partnering with product, data, sales, and client teams on a fast-growing solution.
• Opportunity to make meaningful impact by improving utilization management workflows and helping healthcare organizations deliver better patient outcomes.

To be qualified for this position you have:

• Undergraduate degree in nursing, healthcare administration, business, or other relevant field. 
• 3–4+ years of progressive leadership experience in a healthcare setting to include change management.
• Prior relevant experience in healthcare or utilization management strongly preferred, including experience in leading operations teams.
• Payer experience and understanding of health plan operations.
• Experience in leading teams through change and periods of rapid growth.
• Advanced proficiency in Microsoft Office suite.
• Solid understanding of regulatory and compliance implications within UM workflows, including implications for application of AI.
• Knowledge of industry standards around interoperability, including knowledge of UM platforms, EMR integrations, and 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.

You will set yourself apart with:

• Deep payer-side utilization management expertise with the ability to translate clinical complexity into scalable operational models.
• Proven success building and leading teams through growth, change, and cross-functional execution.
• Strong fluency in AI-enabled clinical workflows with the credibility to influence both executive stakeholders and technical partners.

What you will be doing:

• Owning clinical delivery timelines and planning, coordinated with the overall delivery lead.
• Overseeing pre-sales scoping, timelines, and clinical resource planning to ensure scalable, efficient, and compliant delivery commitments.
• Ensuring clinical scope contract sign-off is governed and consistently executed.
• Creating strong clinical oversight models, including build of clinical tooling to support efficiency and standardization.
• Leading policy mapping and ensuring operational readiness for clinical content execution.
• Owning DAG creation, ongoing policy updates, and DAG maintenance with disciplined change control.
• Providing DAG oversight and accountability for quality, consistency, and operational sustainability.
• Establishing and running SLA auditing, including review of findings and action plans, including close collaboration with clinical account managers
• Leading clinical audits, including bug creation and clinical performance remediation pathways.
• Reviewing product performance and client reporting outcomes and supporting coordinated improvement efforts across teams (engineering, data science, and product).
• Owning clinical release updates and serving as Clinical Release POC for coordinated readiness and communication.
• Driving operational rigor across clinical QA and delivery processes to reduce defects and improve consistency.
• Providing sales support, including demo use case consistency and deep UM workflow expertise.
• Delivering client education on AI, product process, reporting, and serving as clinical SME support for AEs/CSMs.
• Managing and resolving client escalations for clinical issues, ensuring timely triage and resolution.
• Leading AuthAI CR triage and managing AuthAI client escalations, ensuring consistent workflows and rapid issue resolution.
• Partnering in a product dyad to drive clinical program design and requirements build that aligns clinical needs with product execution.
• Supporting development and delivery of client-specific roadmaps from a clinical feasibility and outcomes standpoint.
• Serving as SME and leader for regulatory and accreditation needs.
• Establishing and leading AI and clinical governance models, including extension/connection to UM specific CAB where applicable.
• Providing thought leadership, clinical design and operational support for innovation initiatives (e.g., alpha/beta customer support).
• Overseeing NLP and labeling processes to ensure clinical integrity and operational scalability.
• Acting as clinical partner to Data & Analytics to improve reporting, insights, and clinical performance management.
• Serving as SME for TCoC & VBC (Total Cost of Care and Value-Based Care).
• Acting as clinical SME to establish Availity’s position as a trusted industry advisor in the UM space

Availity culture and benefits: 

• Availity is a certified “Great Place to Work”! Culture is important to us and there are many ways for you to make your mark here!
• We have several Culture teams, a Young Professionals Group, and various ways to engage with fellow Availity associates – if you’re near Jacksonville, we have lots of pop up lunches where lunch is provided for everyone when we can see meetings are taking place and we’ve got teams in the office. 
• Availity is a culture of continuous learning. We have many resources and experts in our tech stack and in our industry that can help get you there too!
• Don’t feel like wearing business attire? Cool, you can wear jeans – we are a casual place.
• We offer a competitive salary, bonus structure, generous HSA company contribution, healthcare, vision, dental benefits and a 401k match program that you can take advantage of on day one! 
• We offer unlimited PTO for salaried associates + 9 paid holidays. Hourly associates start at 19 days of PTO and go up from there with all the same holiday benefits. 
• Interested in wellness? We allow our associates to reimburse up to $250/year for gym memberships, participation in racing events, weight management programs, etc.
• Interested in furthering your education? We offer education reimbursement!
• Availity offers Paid Parental Leave for both moms and dads, both birth parents and adoptive parents. 
• Want to work for an organization that gives back to the community? You’re at the right place! Availity partners with various organizations, both locally and nationally, to raise awareness, funds and morale as our staff members volunteer their time and funds to engage the organizations campaign.

Next steps: 

After you apply, you will receive text/email messages thanking you for applying and then you will continue to receive more text/email messages alerting you as to where you are in the recruitment process. 

Interview process:  

• Recruiter Recorded Video Pre-Screen
• Video Panel Interview
• Video Interview with COO

Video Camera Usage:

Availity fosters a collaborative and open culture where communication and engagement are central to our success.  As a remote first company, we are also camera-first and provide all associates with camera/video capability to simulate the office environment. If you are not able to use your camera for all virtual meetings, you should not apply for this role.

Having cameras on helps create a more connected, interactive, and productive environment, allowing teams to communicate more effectively and build stronger working relationships.  The usage of cameras also enhances security and protects sensitive company information. Video participation is required to ensure that only authorized personnel are present in meetings and to prevent unauthorized access, data breaches, preventing social engineering, or the sharing of confidential information with non-participants.

Disclaimers:

Availity is an equal opportunity employer and makes decisions in employment matters without regard to race, religious creed, color, age, sex, sexual orientation, gender identity, gender expression, genetic information, national origin, religion, marital status, medical condition, disability, military service, pregnancy, childbirth and related medical conditions, or any other classification protected by federal, state, and local laws and ordinances.

Availity is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

NOTICE: Federal law requires all employers to verify the identity and employment eligibility of all persons hired to work in the United States. When required by state law or federal regulation, Availity uses I-9, Employment Eligibility Verification in conjunction with E-Verify to determine employment eligibility. Learn more about E-Verify at http://www.dhs.gov/e-verify.

Click the links below to view Federal Employment Notices.

Family & Medical Leave Act  Equal Employment Law Poster  Pay Transparency  Employee Polygraph Protection Act  IER Right to Work Poster  Important Notice about Employee Rights to Organize and Bargain Collectively with Their Employers