**Responsibilities include:** **Drive initiatives and activities to enhance performance of the department with an emphasis on efficiency and effectiveness.** **Develops and leads a team to drive optimization across the Clinical Operations Landscape (including UM, CM, behavioral health, pediatrics, and LTC products).** **Develop, monitor and report appropriate metrics to improve overall out comes. This to include dashboard creation, maintenance and auditing, and business leader coaching. Metric types include compliance activities, CM and UM activities, clinical status outcomes, medical cost trend implications for CM and UM, staffing/ attrition recommendations, medical cost savings initiatives and tracking, new program design staffing models, and more** **.** **Design and lead comprehensive implementation plans and performs impact analysis to identify barriers or risks to successful implementation.** **Advocate for adoption and success of plan by establishing metrics and collaborative relationships with key stakeholders; Plan staff and vendor staff as applicable.** **Ensure data integrity is upheld to the highest standards; collaborate with Finance, Population health, Quality, Enterprise analytics, and Delivery System teams to ensure continuity across the Organization.** **Evaluate departmental operations with a focus on process improvement.** **Manage portfolio of projects; inclusive of contract and benefit changes, and other related activities as assigned.** **Establish and monitor audit process to ensure adherence to specific project goals.** **Collaborate with Performance Improvement department, Training, Program Design, Regulatory/Compliance and other internal departments to ensure efficient implementation of change.** **Hire, coach, and train staff to ensure smooth operations** **Participate and represent the clinical business on business implementation of new products.** **Additional duties as assigned** **Required Qualifications:** **Masters degree and/or BS, BA in a health care related field** **Experience in medical care management, utilization management or other healthcare management position** **Strategic thinker with strong collaboration and the ability to work effectively with a variety of internal personnel and external organizations, as warranted** **Experience in process improvement, ability to devise innovative and practical solutions to solve complex problems** **Highly creative problem solver adept at liaising between teams to drive results** **Preferred Qualifications:** **Experience with complex data system(s) and reporting software such as Tableau or similar platform** **Project Management skills and capabilities** **Previous experience managing a team and desire to lead** WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.