Alignment Health · 8 hours ago
Vice President Clinical Transformation
United States
Full-time
Onsite
Director/Executive
$198K/yr - $297K/yr
10+ years expAlignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most. The Vice President of Clinical Transformation is responsible for the strategic development and improvement of clinical programs, ensuring alignment with corporate strategy and enhancing health outcomes for members.
Health CareHospitalMedicalMedical DeviceWellness
Responsibilities
Develop and execute a comprehensive clinical transformation strategy that supports medical cost management, quality performance (e.g., STAR ratings, HEDIS, CAHPS), and member engagement goals
Design, implement, and continuously refine evidence-based clinical programs and interventions targeting key disease states, utilization patterns, and population health priorities
Collaborate with Regional Medical Directors, Operations, Pharmacy, Network, and Analytics teams to identify opportunities for clinical innovation and improvement
Lead the translation of clinical insights into operationally executable programs that drive measurable outcomes
Lead cross-functional initiatives integrating clinical operations, population health, risk adjustment, and quality improvement programs
Evaluate and recommend emerging technologies—AI-driven triage, clinical decision support, remote monitoring, and telehealth—to improve member outcomes and program efficiency
Oversee end-to-end lifecycle of clinical programs — from concept design through pilot, rollout, evaluation, and scaling
Establish program KPIs and outcomes measurement frameworks; monitor performance and ensure continuous quality improvement
Integrate clinical analytics and predictive modeling to identify high-impact intervention opportunities and measure ROI
Ensure ongoing alignment of clinical program strategies with CMS, HEDIS, CAHPS, HOS, Stars, and risk adjustment requirements with a focus on optimizing Medicare Advantage performance
Partner with provider networks and care management teams to enhance care coordination, reduce avoidable utilization, and improve chronic disease management
Identify, onboard, and manage third-party vendor partners to scale clinical programs and services
Establish performance expectations and metrics for vendor partners; monitor outcomes and hold vendors accountable for results
Facilitate cross-functional collaboration with vendors, internal analytics, and clinical teams to optimize program performance
Develop standardized processes, workflows, and toolkits for clinical intervention design and delivery
Implement process improvement methodologies to streamline clinical operations and optimize resource utilization
Drive adoption of technology and data solutions that enable precision targeting, automation, and real-time insights
Work cross-functionally with key leaders in Clinical, Quality, Provider/Network, and Actuarial to align clinical optimization initiatives with organizational goals
Serve as a strategic advisor to the executive team on trends in population health management, value-based care, and clinical innovation
Build strong relationships with providers, vendors, and community partners to advance shared clinical outcomes
Qualification
Required
10+ years of progressive leadership experience in managed care, health plan operations, or population health management
Deep understanding of Medicare Advantage regulations, STARS and HEDIS metrics, and value-based care models
Proven track record of developing and implementing scalable clinical programs that improve outcomes and reduce total cost of care
Experience leveraging analytics and technology to drive clinical and operational improvement
Strong familiarity with utilization management, care management, and risk adjustment functions
Master's degree in Healthcare Administration, Public Health, or related field
Strategic thinker with strong execution discipline
Excellent leadership, influence, and collaboration skills across cross-functional teams
Strong analytical mindset and comfort interpreting clinical and financial data
Exceptional communication and presentation abilities
Demonstrated commitment to innovation, member-centric care, and continuous improvement
Company
Alignment Health
Alignment Health provides eldercare services.
501-1000 employees
H1B Sponsorship
Alignment Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (3)
2024 (12)
2023 (17)
2022 (13)
2021 (11)
2020 (6)
Funding
Current Stage
Public CompanyTotal Funding
$696.05MKey Investors
K2 HealthVenturesWarburg PincusGeneral Atlantic
2024-11-15Post Ipo Debt· $321.05M
2024-01-09Private Equity
2021-03-26IPO
Leadership Team
Dawn Maroney
President, Alignment Health | CEO, Alignment Health Plan
John Kao
CEO and Founder
Recent News
Alignment Healthcare USA, LLC
2025-10-31
Alignment Healthcare USA, LLC
2025-10-14
Company data provided by crunchbase