[Hiring] Vice President Clinical Operations @Alight

Role Description

The Vice President Clinical Operations is the senior clinical leader overseeing absence, disability, and leave management services. They ensure clinical quality, rigorous medical decisions, and integration of expertise into claims operations. Collaborating with Operations, Sales, and Clients 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 cases.
• 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 ensuring 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.

Qualifications

• 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.

Requirements

• By applying for a position with Alight, you understand that, should you be made an offer, it will be contingent on your undergoing and successfully completing a background check consistent with Alight’s employment policies.
• Alight requires all virtual interviews to be conducted on video.

Benefits

• Comprehensive total rewards package supporting mind, body, wallet, and life.
• Health, dental, and vision coverages starting Day One.
• Wellbeing programs.
• Retirement plans with contribution matching.
• Generous time off and parental leave.
• Continuing education and career growth opportunities.

Company Description

At Alight, we believe a company’s success starts with its people. We Champion People, help our colleagues Grow with Purpose, and encourage colleagues to “Be Alight.” We are passionate about connecting purpose with impact.

Alight empowers clients to build a healthier and more financially secure workforce by unifying the benefits ecosystem across health, wealth, wellbeing, navigation, and absence management.