Director, Clinical Operations And Population Health - Emory Health Plan
Emory University
Atlanta, GA, US
Primarily on campus with potential remote work options.
Active unrestricted rn licensure in georgia
7+ years clinical operations leadership experience
Strong utilization management and prior authorization oversight
Emory University is seeking a Director of Clinical Operations and Population Health for its Emory Health Plan. The role involves strategic leadership in population health initiatives, clinical operations, and performance management, requiring extensive experience in healthcare
Job Summary
The Director serves as the primary clinical execution partner for Emory Health Plan's population health and value-based care strategy.
This role requires independent oversight of utilization management activities including prior authorization and level of care determination.
The successful candidate will lead complex patient case reviews and govern disease management programs across multiple chronic conditions.
Matching Summary
Match Score: 85
Emory University is seeking a Director of Clinical Operations and Population Health for its Emory Health Plan. The role involves strategic leadership in population health initiatives, clinical operations, and performance management, requiring extensive experience in healthcare.
Skills & Requirements
Must-have
Active unrestricted RN licensure in Georgia
7+ years clinical operations leadership experience
Strong utilization management and prior authorization oversight
Independent navigation of claims data and population health dashboards
Experience governing disease management programs
Proven ability to hold vendors accountable to SLAs
Nice-to-have
Certified Case Manager (CCM) credential
Master's degree in healthcare or business fields
Experience with self-funded employer health plans
Knowledge of VBC contract mechanics and shared savings
Behavioral health integration expertise
NCQA accreditation readiness experience
Key Requirements
Active RN license in Georgia
Minimum 7 years progressive clinical operations leadership
Demonstrated track record in population health programs