Clinical Operations

• Lead Medicaid Clinical Operations, including clinical and nonclinical teams supporting utilization management, care management/service coordination, program operations, process improvement, training, and project execution.
• Establish clear operating rhythms, accountability structures, workforce productivity expectations, and performance management processes across distributed clinical operations teams.
• Build and sustain an engaged, high-performing leadership culture focused on associate development, retention, operational discipline, and measurable outcomes.
• Develop and execute Medicaid clinical operations strategies that support growth, market expansion, state contract requirements, enterprise priorities, and scalable operating model transformation.
• Translate clinical strategy, market commitments, and program designs into operational workflows, staffing models, performance targets, and implementation plans.
• Oversee Medicaid utilization management and care management/service coordination functions, ensuring consistent clinical practices, regulatory compliance, timely decision-making, and appropriate escalation management.
• Strengthen care navigation, member access, provider coordination, and interventions that reduce avoidable utilization and improve health outcomes.
• Partner with Product, Technology, Data, Analytics, and Operations teams to translate Clinical Operation’s needs, regulatory requirements, workflow gaps, and performance priorities into clear business requirements, use cases, and solution expectations.
• Establish, monitor, and improve key performance metrics, including quality, compliance, cost of care, access, utilization, productivity, service levels, member experience, provider experience, revenue, margin, and client or contract performance commitments.

VP, Medicaid Clinical Operations

• Facility management of a newly constructed electric vehicle battery manufacturing plant
• Manage hard services of MEP equipment within the facility
• Ensure seamless environment for uninterrupted manufacturing
• Oversee operational performance across both day and night shifts
• Manage supervisors and staff, including hiring and performance evaluations
• Provide technical and management guidance to the team

Clinical Operations jobs in Kentucky

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VP, Medicaid Clinical Operations

Operations & Maintenance Site Operations Manager