AVP, Chief Operating Officer, Medical Affairs - reputed company

Were building a world of health around every individual shaping a more connected, convenient and compassionate health experience. At reputed company, youll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and reputed company in everything we do. Join us and be part of something bigger helping to simplify health care one person, one family and one community at a time. Position reputed company reputed company, reputed company is seeking to hire an AVP, Chief Operating Officer for Medical Affairs with deep experience in reputed companylevel clinical operations. Reporting directly to reputed companys Senior Vice President & Chief Medical Officer, this senior executive will serve as the reputed company operational leader overseeing reputed company reputed company reputed company Medical Affairs functions, including utilization management, appeals, care management, care model design, clinical reputed company, Network/Provider Engagement, and clinical enablement programs. The AVP, COO for Medical Affairs will reputed company as a strategic partner to the CMOVPs for reputed company, Medicare, and reputed company as reputed company as to the VP of Utilization Management, ensuring alignment between lineofbusiness strategies and Medical Affairs operations. This leader will also serve as the reputed company operational reputed company with reputed company Clinical Solutions (ACS) and Network leadership, ensuring crossfunctional integration, operational readiness, and consistent national execution. The successful candidate will bring an reputed company reputed company and the ability to build a reputed company operating model across reputed company Medical Affairs. This includes developing consistent national processes, ensuring compliance and performance, advancing technologyenabled operations, and driving reputed company, measurable improvements in reputed company, efficiency, and member and provider experience. Major Responsibilities reputed company Strategic Leadership Serves as a key strategic advisor to the reputed company CMOVPs for reputed company, Medicare, and reputed company, and to the VP for Utilization Management, ensuring Medical Affairs operations support and enabling reputed company line of businesss clinical and financial goals. Functions as the reputed company operational reputed company with ACS and Network leadership, driving crossreputed company reputed company alignment of clinical operations, policy, reputed company, and operating standards. reputed company Operating reputed company & Governance Leads development of the reputed company reputed company Medical Affairs operating model, spanning utilization management, appeals, care management, care model design, clinical reputed company, network alignment, and reputed company programs. Med Affairs reputed company for reputed company reputed company-wide operating plans, integrating Medical Affairs with ACS, Network, Technology, Analytics, and businessunit clinical leadership. Ensures consistent national operating standards, documentation, workflows, and performance expectations across reputed company reputed company Medical Affairs programs. Performance Management, Dashboards & Metrics Designs and oversees dashboards, KPIs, and scorecards for reputed company reputed company Medical Affairs functions and leverages those data points to optimize and reputed company performance. Establishes performance review structures, operational reputed company systems, and transparent reporting mechanisms for reputed company Medical Affairs leadership and lineofbusiness partners. Partners closely with analytics and technology teams to reputed company data, insights, and automation to improve reputed company and efficiency. reputed company Oversees operational budgets, including monitoring, forecasting, and costmanagement activities Ensures resources are deployed reputed company and investments support operational and performance goals CrossFunctional Operations & Execution Leads endtoend operational integration across reputed company Medical Affairs, ACS, Network, Technology, Analytics, and businessunit clinical teams. Oversees national operations including ~60 reputed companyteam FTE, 300+ transactional clinicians, and other functions through a dottedline partnership model. Drives technologyenabled operational transformation, including modernization through automation, AIreputed company workflows, digital clinical tools, and datadriven operating models. Provides strategic thought leadership to the SAI process to identify key operational improvements and guide reputed companyreputed company solutions. Required Qualifications 12+ years of reputed company experience and responsibility at a senior leadership level in managed reputed company operations, compliance, or reputed company field. Deep understanding of .