VICE PRESIDENT CLINICAL OPERATIONS

Vice President Clinical Operations (Pennsylvania/Hybrid) Jefferson Health Plans, in partnership with The French Group, seeks an exceptional leader in Care Management to serve in the critical, highly visible role of VP Clinical Operations. Owned by Jefferson Health and headquartered in Philadelphia, PA, Jefferson Health Plans (the new corporate marketing name for Health Partners Plans) continues to offer Medicaid and CHIP products in Pennsylvania and Medicare Advantage products in both Pennsylvania and New Jersey with a high-quality network of providers. Reporting to the SVP Chief Medical Officer for Jefferson Health Plans, this VP serves as a key member of the health plan leadership team. The VP provides the strategic direction and clinical operational oversight for Precertification, Inpatient Services, Provider Appeals, DME and Ancillary Services Departments for the health plans. Responsibilities Lead and manage high-performing care management teams. Provide strategic direction and clinical operational oversight for Precertification, Inpatient Services, Provider Appeals, DME and Ancillary Services Departments. Qualifications Minimum of 7 years of progressive health plan leadership experience, including Medicaid and Medicare products. RN licensed in PA with a Bachelor’s Degree required; Master’s preferred. #J-18808-Ljbffr The French Group