Description

Location: This position is located at our Dublin, OH campus with hybrid flexibility .

Who we are

Founded in 1999 and headquartered in Central Ohio, we’re a privately-owned, independent healthcare navigation organization. We believe that no one should have to navigate the cost and complexity of healthcare alone, and we’re on a mission to make healthcare simpler and more effective for our millions of members. Our big-hearted, tech-savvy team fights to ensure that our members get the care they need, when they need it, at the most affordable cost – that’s why we call ourselves Healthcare Warriors®.

We’re committed to building diverse and inclusive teams – more than 2,000 of us and counting – so if you’re excited about this position, we encourage you to apply – even if your experience doesn’t match every requirement.

About the role

The Vice President (VP), Clinical Engagement is responsible for the design, execution and continuous improvement of Quantum Health’s clinical services and engagement model, ultimately driving value for our employer clients, their members, and our providers and partners. The VP, Clinical Engagement lead s the performance of clinical services, including care management (care coordination, case management and d isease management ) , utilization management, clinical specialty services, population health and lifestyle coaching programs, ensuring seamless program delivery, best-in-class member experience and exceptional whole person care focused clinical outcomes .

Uniting and leading the team around a shared vision, this servant leader will champion significant change initiatives and will develop and implement strategies that simplify and improve clinical outcomes, operational effectiveness and quality as Quantum Health continues its rapid growth. The leader will build and develop clinical teams through influence and inspirational leadership that advances the company’s inclusive and collaborative culture. This highly influential, strategic leadership role reports to the Chief Medical Officer.

What you’ll do (Essential Responsibilities)

Inspirational Leadership

Build and develop strong clinical teams. Provide visionary leadership, advancing communication, collaboration, innovation, and continuous improvement across cross-functional teams to achieve organizational objectives.
Foster a positive and inclusive environment that promotes professional growth, job satisfaction, and retention.
U tilize a teamwork approach to build a culture of clinical excellence to achieve top performance of Quantum Health clinicians and support staff (nurses, social workers, therapists, lifestyle/health coaches, coordinators, etc. ) .

Clinical Program Design and Development

Collaborate with cross-functional teams to develop innovative clinical programs aligned with member needs, employer objectives, and industry trends.
Conduct comprehensive assessments and market research to identify opportunities for enhancement (e.g. health equity, community engagement, social determinants of health, etc . )
Develop and refine clinical protocols, guidelines, and quality standards.
Ensure adherence to regulatory and compliance requirements.

Clinical Program Delivery

Oversee the end-to-end delivery of clinical programs, including implementation, management , auditing and evaluation .
Build and lead a high-performing clinical operations team responsible for program execution.
Develop and implement key performance indicators (KPIs) to measure program effectiveness, identify improvement opportunities, and ensure alignment with client performance guarantees/service level agreements (SLAs).
Meet/exceed compliance standards with all applicable regulatory bodies, such as the Utilization Review Accreditation Commission (URAC), among others.

Clinical Operations Strategy

Develop and execute the clinical operations strategy in alignment with the company's overall business objectives with a focus on scalability through 3-5x growth.
Optimize clinical operations processes and workflows to improve efficiency and effectiveness.
Identify and implement solutions to enhance clinical program delivery and data management.
Manage and allocate clinical operations budget to maximize resource utilization.

Data Analysis and Insights

Leverage data to measure outcomes, identify trends, and inform decision-making.
Develop reporting and analytics capabilities to communicate performance to stakeholders.
Identify opportunities to improve clinical program effectiveness based on data-driven insights.

Thought Leadership

Provide clinical subject matter expertise as needed to a variety of non-clinical partners, including Sales, Client Engagement, Operations Leaders, Benefits Consultants, and Clients/Prospects.
Present clinical content to various stakeholders, including executives, medical directors, board members/investors, and more.
Build relationships with employer clients and their partners , gather feedback, and help design pathways to eliminate barriers to care and achieve optimal clinical quality and outcomes. All other duties as assigned.

What you’ll bring (Qualifications)

Education: Bachelor’s degree required; Graduate degree preferred.
Licensure: Active, unrestricted license in good standing to practice as a Registered Nurse (RN) , Advanced Practice Registered Nurse (APRN), or Licensed Social Worker/Licensed Independent Social Worker (LSW/LISW) in your primary state(s) of residence required; multistate licensure preferred.
Experience: 10+ years in healthcare operations leadership, ideally within benefits, navigation/care coordination, telehealth/virtual care, and/or managed care organizations.
5+ year of direct clinical practice/patient care experience
7+ years’ experience coaching and leading high-performing clinical teams; this includes coaching individual performance and managing through significant change. Demonstrated expertise in designing and implementing successful clinical programs.
Proven experience leading collaborative, consensus-generating committees or workgroups with conviction and decisiveness.
Expert knowledge of the healthcare industry, including payer, provider, and employer landscapes; Experience working with employer-sponsored health insurance plans preferred.
Strong business acumen and analytical skills; ability to quickly aggregate and analyze information and arrive at data-informed decisions.
Experience and comfort working across highly matrixed, complex organizations
Excellent communication skills with the ability to build strong relationships with diverse stakeholders at all levels; Comfortable translating clinical concepts to non-clinical audiences.
Strong administrative/technical skills; Comfort working on a PC using Microsoft Office (Outlook, Word, Excel, PowerPoint), IM/video conferencing (Teams & Zoom), and telephones efficiently.
A high degree of personal accountability and trustworthiness, a commitment to working within Quantum Health’s policies, values and ethics, and to protecting the sensitive data entrusted to us.

#LI-Hybrid

#LI-HW1

What’s in it for you

Compensation: Competitive base and incentive compensation
Coverage: Health, vision and dental featuring our best-in-class healthcare navigation services, along with life insurance, legal and identity protection, adoption assistance, EAP, Teladoc services and more.
Retirement: 401(k) plan with up to 4% employer match and full vesting on day one.
Balance: Paid Time Off (PTO), 7 paid holidays, parental leave, volunteer days, paid sabbaticals, and more.
Development: Tuition reimbursement up to $5,250 annually, certification/continuing education reimbursement, discounted higher education partnerships, paid trainings and leadership development.
Culture: Recognition as a Best Place to Work for 15+ years, dedication to diversity, philanthropy and sustainability, and people-first values that drive every decision.
Environment: A modern workplace with a casual dress code, open floor plans, full-service dining, free snacks and drinks, complimentary 24/7 fitness center with group classes, outdoor walking paths, game room, notary and dry-cleaning services and more!

What you should know

Internal Associates: Already a Healthcare Warrior? Apply internally through Jobvite.
Process: Application > Phone Screen > Online Assessment(s) > Interview(s) > Offer > Background Check.
Diversity, Equity and Inclusion: Quantum Health welcomes everyone. We value our diverse team and suppliers, we’re committed to empowering our ERGs, and we’re proud to be an equal opportunity employer .
Tobacco-Free Campus: To further enable the health and wellbeing of our associates and community, Quantum Health maintains a tobacco-free environment. The use of all types of tobacco products is prohibited in all company facilities and on all company grounds.
Compensation Ranges: Compensation details published by job boards are estimates and not verified by Quantum Health. Details surrounding compensation will be disclosed throughout the interview process. Compensation offered is based on the candidate’s unique combination of experience and qualifications related to the position.
Sponsorship: Applicants must be legally authorized to work in the United States on a permanent and ongoing future basis without requiring sponsorship.
Agencies: Quantum Health does not accept unsolicited resumes or outreach from third-parties. Absent a signed MSA and request/approval from Talent Acquisition to submit candidates for a specific requisition, we will not approve payment to any third party.

Reasonable Accommodation: Should you require reasonable accommodation(s) to participate in the application/interview/selection process, or in order to complete the essential duties of the position upon acceptance of a job offer, click here to submit a recruitment accommodation request.

Recruiting Scams: Unfortunately, scams targeting job seekers are common. To protect our candidates, we want to remind you that authorized representatives of Quantum Health will only contact you from an email address ending in @quantum-health.com. Quantum Health will never ask for personally identifiable information such as Date of Birth (DOB), Social Security Number (SSN), banking/direct/tax details, etc. via email or any other non-secure system, nor will we instruct you to make any purchases related to your employment. If you believe you’ve encountered a recruiting scam, report it to the Federal Trade Commission and your state’s Attorney General .

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Vice President, Clinical Engagement