VP Clinical Operations

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Job Summary

The Vice President of Clinical Operations provides strategy and leadership to optimize clinical operations across the enterprise, translating clinical strategy into a scalable, measurable, and cost-effective operating system. This role serves as the primary bridge between strategy and execution, ensuring clinical programs are standardized, compliant, and performance-driven across all markets.

The VP establishes and implements processes to ensure clinical operations and vendor-delivered services meet state, federal, and regulatory requirements, while consistently achieving quality and compliance standards. In partnership with leadership, this role drives alignment to enterprise priorities and contributes to strategies that deliver high-quality, cost-effective member care.

The VP is accountable for delivering measurable impact on medical cost trend, quality outcomes, operational efficiency, and growth, while strengthening vendor performance, advancing workforce capability through clinical systems training, and enabling differentiated clinical models for RFPs and new business.

Key responsibilities include driving clinical program performance and ROI, delivering measurable impact on medical cost trend, outcomes, and efficiency; owning the enterprise clinical operating model to ensure standardized, scalable execution through data-driven performance management. The VP advances workforce capability, training and vendor partnerships across a matrixed organization to align strategy, execution, and enterprise priorities and growth efforts.

• Lead clinical program performance and ROI, delivering measurable impact on medical cost trend, quality outcomes, and administrative efficiency; establish KPIs aligned to HBR and affordability targets.
• Own the enterprise clinical operating model, including workflows and policies & procedures, ensuring standardized, scalable, and compliant execution across markets.
• Drive vendor strategy and performance, establishing outcome-based KPIs, measuring ROI, and guiding partnership decisions (including buy vs. build) to optimize value.
• Embed performance management and analytics into operations, enabling data-driven decision-making and closed-loop accountability across clinical programs.
• Champion workforce capability and clinical systems training, ensuring teams consistently execute standardized workflows and deliver high-quality, efficient care.
• Oversee operational audit and continuous improvement, assessing adherence to workflows and performance standards and driving systemic process and efficiency enhancements.
• Lead growth and RFP support, designing scalable, differentiated clinical models that strengthen competitive positioning and support market expansion.
• Partner cross-functionally across the enterprise, ensuring alignment of strategy, execution, and organizational priorities.

Education/Experience:

• Bachelor’s Degree.
• Master’s preferred in healthcare administration, nursing, or related field.
• Business and/or Operations advanced education, training, or degree encouraged.
• 10 or more years☒of progressive leadership experience in clinical programs and operations.

Other Skills:

• Strong leadership, analytical, and communication skills, as well as a proven track record in clinical program management and operational strategy.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.