Regional Director, Clinical Operations

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Regional Director, Clinical Operations in United States.

This is a high-impact clinical operations leadership role focused on driving performance across multiple healthcare markets within a value-based care environment. The role sits at the intersection of clinical operations, population health, and physician enablement, with responsibility for ensuring strong execution across quality, risk adjustment, and cost-of-care initiatives. You will lead multi-market operational strategy and execution, ensuring that clinical and administrative workflows are aligned, scalable, and performance-driven. This position requires a leader who thrives in complex, data-driven healthcare environments and can translate strategy into measurable operational outcomes. You will work closely with market leaders, physicians, and cross-functional teams to improve patient outcomes and operational efficiency. The role is central to strengthening care delivery infrastructure and enabling consistent performance across regions.

• Lead and oversee clinical operations across multiple markets, including Risk Adjustment, Quality (HEDIS), and Cost of Care programs
• Design, implement, and enforce standard operating procedures, SLAs, and governance frameworks to ensure operational consistency and scalability
• Manage end-to-end workflows such as clinical documentation review, coding validation, chart abstraction, and provider engagement processes
• Partner with market leadership to monitor performance metrics, identify gaps, and execute corrective action plans
• Define and track KPIs, conduct root-cause analysis, and drive continuous process improvement initiatives
• Oversee operational budgets, vendor relationships, and resource allocation to ensure efficiency and performance optimization
• Collaborate with data, analytics, and technology teams to enhance dashboards, reporting capabilities, and automation initiatives
• Support workforce planning, including staffing, recruiting, training, and performance management for clinical operations teams

Requirements:

• 5+ years of healthcare operations experience, preferably in value-based care or population health environments
• 3+ years of experience leading multi-market Risk Adjustment and/or Quality programs
• Bachelor’s degree required; advanced degree preferred
• Strong expertise in HEDIS, risk adjustment coding, and healthcare performance metrics
• Experience working with claims, EMR/EHR data, and clinical documentation workflows
• Proven ability to lead operational teams, manage vendors, and drive cross-functional collaboration
• Strong analytical skills with experience in KPI development, dashboards, and performance reporting
• Lean Six Sigma or similar process improvement certification preferred
• Strong leadership, communication, and problem-solving skills with the ability to operate in complex, fast-paced environments

Benefits:

• Competitive salary range aligned with experience and qualifications (approx. $153,000 – $191,300)
• Remote-first work arrangement within the United States
• Comprehensive medical, dental, and vision insurance coverage
• Opportunity to work in a mission-driven organization focused on improving healthcare outcomes
• Strong emphasis on professional development and leadership growth
• Exposure to large-scale, multi-market clinical operations transformation initiatives
• Collaborative and impact-oriented work environment.