Clever Care Health Plan · 5 days ago
Vice President, Population Health Management
Huntington Beach, CA
Full-time
Hybrid
Senior Level, Lead/Staff
$255K/yr - $275K/yr
10+ years expClever Care Health Plan is one of Southern California’s fastest-growing Medicare Advantage plans. The Vice President of Population Health Management provides enterprise-wide leadership for strategies that integrate utilization management, care management, and population health initiatives to improve quality, affordability, and member health outcomes.
Health Care
Responsibilities
Leads the development and execution of the enterprise Population Health Management (PHM) strategy in close partnership with the Health Plan Chief Medical Officer, aligning utilization management, care management, quality, and population health priorities to improve outcomes, affordability, and regulatory performance
Provides executive oversight of clinical performance across population health programs, including the development and oversight of disease management initiatives, ensuring evidence-based care models, quality outcomes, and regulatory performance, including Medicare Advantage quality measures such as Stars, HEDIS, and CAHPS, are embedded into program design, execution, and ongoing performance monitoring
In partnership with the Health Plan Chief Medical Officer, leads joint operational governance with IPAs and MSOs, including oversight of utilization management and care management functions, performance reporting, and accountability for agreed-upon clinical, quality, and cost outcomes
Provides strategic direction for the use of analytics, predictive modeling, and risk stratification to inform population health interventions, guide resource allocation, and enable data-driven decision-making across utilization management, care management, and quality initiatives
Provides strategic guidance, direction, and overall leadership of utilization management and care management teams and processes in support of the enterprise population health strategy; leads and mentors teams, builds workforce and succession plans for critical roles, and oversees population health vendors and platforms to ensure performance accountability, operational readiness, and regulatory compliance
Qualification
Required
10+ years of progressive leadership experience in population health management, clinical operations, medical management, care management, and/or value-based care within a health plan, managed care, or comparable healthcare environment
Demonstrated executive-level leadership experience with accountability for strategy, clinical performance, operational outcomes, and cross-functional collaboration
Bachelor's degree in healthcare administration, business administration, nursing, public health, social work, or a related field preferred; or an equivalent combination of education and significant, progressive leadership experience
Active clinical licensure (e.g., Registered Nurse [RN] license in the State of California) is preferred but not required
Excellent oral and written communication and interpersonal skills
Rapid problem resolution
Exceptional attention to detail while multi-tasking
Ability to work independently and collaboratively within a team
Strong organizational skills
Ability to communicate, facilitate and problem-solve with people of all levels of the organization, as well as provider networks, vendors and constituents
Ability to perform analysis and apply sound reasoning in problem solving
Ability to manage time and prioritize tasks
Ability to solve practical problems and deal with a variety of concrete variables in situations where some standardization exists; ability to collect and analyze data, draw valid conclusions and actively contribute to the strategic interventions that support the departmental goals
Effective management and leadership abilities
Preferred
Bachelor's degree in healthcare administration, business administration, nursing, public health, social work, or a related field preferred
Advanced degrees such as an MBA, MHA, MPH, MSN, or MSW are preferred but not required
Active clinical licensure (e.g., Registered Nurse [RN] license in the State of California) is preferred but not required
Company
Clever Care Health Plan
Clever Care Health Plan is a healthcare company that provides health insurance for medicare services.
201-500 employees
H1B Sponsorship
Clever Care Health Plan 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 (2)
2023 (4)
2022 (3)
Funding
Current Stage
Growth StageTotal Funding
unknown2021-11-01Series Unknown
Leadership Team
Karen Walker Johnson
Interim Chief Operations Officer
Khaliq Siddiq
Chief Medical Officer
Recent News
MedCity News
2025-10-30
Clever Care Health Plan
2025-08-29
Company data provided by crunchbase