Note: The job is a remote job and is open to candidates in USA. Alight Solutions is a company focused on empowering clients to build a healthier workforce through a unified benefits ecosystem. The Vice President of Clinical Operations will oversee absence, disability, and leave management services, ensuring clinical quality and collaboration with various teams to enhance employee outcomes and drive business growth.

Responsibilities

• Acting as the lead clinical expert for leave and disability case management, ensuring accurate claim decisions and effective return-to-work plans
• Providing expert clinical consultation on complex, high risk, or escalated
• Overseeing clinical quality programs, including audits, peer reviews, nurse over reads, and retrospective reviews to ensure consistency and best practices
• Leading and facilitating regular clinical roundtables to guide case strategy, functional capacity assessment, and care planning
• Managing and evaluating physician consultants and senior clinical staff (RNs). Overseeing recruitment, credentialing, performance, and quality of physician reviewers, IME providers, and peer review vendors. Reviewing peer review productivity, quality, and compensation for appropriateness
• Leading clinical credentialing meetings and ensure adherence to licensure and certification requirements
• Designing and delivering ongoing clinical training for case managers, nurses, and physician consultants. Providing guidance and training for sensitive situations, including threats to self or others
• Overseeing development of clinical content, including LOA guides, disability reference materials, attending physician forms, and onboarding curricula. Leading continuing medical education initiatives and external clinical lecture programs
• Supporting client relationship management through participation in quarterly and annual reviews
• Providing clinical expertise during finalist meetings, RFPs, and sales presentations
• Developing and presenting materials that articulate the clinical model, peer review approach, and value proposition. Performing targeted clinical data analysis to help clients understand trends, outcomes, and opportunities for improvement
• Providing clinical input into technology platforms, diagnostic coding, vendor integrations, and clinical thought design. Designing and reviewing reports, metrics, and analytics demonstrating clinical outcomes, ROI, productivity, and quality

Skills

• Have MD, DO, or equivalent doctoral degree in a healthcare field
• Possess active clinical licensure, board certification
• 5+ years of leadership experience in disability, leave, or absence management
• Display compelling communication, presentation, and analytical skills
• Have extensive experience with clinical auditing, quality programs, and interdisciplinary teams
• Demonstrate promoting diversity, collaboration, and a global mindset across clinical teams
• Be a subject matter expert who has served as a trusted advisor to senior leadership on clinical risk, strategy, and performance
• Align with company strategy, policies, and ethics

Benefits

• Health, dental and vision coverages starting Day One
• Wellbeing programs
• Retirement plans with contribution matching
• Generous time off
• Parental leave
• Continuing education
• Career growth opportunities
• Flexible working arrangements wherever possible
• Competitive total rewards package
• Continuing education & training
• Bonus and/or incentive eligibility are determined by role and level
• Comprehensive benefits package; for specific details on our benefits package, please visit: Wellbeing and Benefits Selector Page - Alight

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