Vice President of Health Plan Operations
confidentialLong Beach (CA)
Vice President of Health Plan Operations
Posted 7 days ago
confidentialLong Beach (CA)
SENIORITY
Manager
About the role
Vice President of Health Plan Operations
About the Company:
Reputable managed care company for government-sponsored healthcare IndustryHospital & Health CareTypePublic Company Founded1980Employees10,001+Categories Health Care HospitalMedicalHealth & Wellness Life and Health Managed Care Specialtiesmanaged careprimary care clinicsmedicaidand medicare
About the Role:
The Company is seeking a Vice President of Health Plan Operations to provide executive-level strategy and leadership for the development and administration of state health plan operational functions, programs, and services. The successful candidate will be responsible for ensuring functional operations, contractual compliance, and alignment with health plan member satisfaction, retention, quality, and financial goals. This role involves supporting executive strategy development, directing and coordinating state health plan operations, and being accountable for the performance of health plan operating metrics. The VP will also be involved in planning, organizing, and coordinating the operations of various state health plan programs, including Medicaid, CHIP, Medicare, and Marketplace. Applicants must have at least 12 years of experience in health care operations, administration, and/or provider services, with a minimum of 7 years in a management or leadership role. Deep experience with Medicare, Medicaid, and Marketplace plans is essential, as is a background in claims-related activities and prompt pay laws. The role requires a candidate with a proven track record of adaptability, strong organizational and time-management skills, and the ability to work collaboratively across a matrixed organization. Project management experience, excellent communication skills, and proficiency in the Microsoft Office suite are also necessary. The VP will be expected to lead a high-performance team, drive continuous improvement, and ensure the team is dedicated to best-in-class solutions. Hiring Manager TitleHealth Plan President FunctionsOperations
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