Medical VP in San Juan at TPIS

We are conducting a executive search for an experienced Vice President, Medical Affairs. This executive will provide strategic clinical leadership and operational oversight for a complex healthcare organization, ensuring clinical excellence, regulatory compliance, quality outcomes, and effective collaboration with healthcare providers and executive leadership.

• Provide strategic leadership for clinical operations, medical governance, and healthcare quality initiatives.
• Develop and implement medical policies, clinical protocols, and care management programs.
• Oversee utilization management, prior authorization, case management, disease management, and clinical review activities to ensure evidence-based, cost-effective care.
• Ensure clinical review processes align with applicable federal coverage determinations, medical necessity guidelines, and regulatory requirements.
• Foster strong relationships with physician organizations, hospitals, provider groups, and other healthcare stakeholders to support value-based care initiatives.
• Ensure compliance with all applicable federal, state, and local healthcare regulations, accreditation standards, and organizational policies.
• Participate in executive committees related to clinical quality, pharmacy, credentialing, medical governance, and organizational performance.
• Lead, mentor, develop, and evaluate clinical leadership teams while promoting accountability and operational excellence.
• Support organizational initiatives focused on improving clinical outcomes, operational performance, and quality of care.
• Perform other executive-level responsibilities as assigned.

• Doctor of Medicine (MD) degree required.
• Minimum of 10 years of progressive experience in clinical leadership, managed care, healthcare administration, or complex healthcare operations.
• Minimum of 6 years of leadership experience supervising multidisciplinary teams.
• Active Medical License to practice in Puerto Rico is required.

• Executive leadership experience within highly regulated healthcare environments.
• Strong knowledge of utilization management, quality improvement, clinical operations, and regulatory compliance.
• Experience collaborating with physicians, hospitals, and provider networks.
• Demonstrated ability to lead multidisciplinary teams and drive strategic initiatives.

• Advanced Spanish (written and verbal)
• Advanced English (written and verbal)

Competitive compensation package, commensurate with experience.

TPIS is an Equal Opportunity Employer (EEO Employer / Affirmative Action for Females / Disabled / Veterans). We comply with all Federal, State and Local laws regarding nondiscrimination.