Lead, Strategy & Operations of Health Plans (Hybrid)

What We Provide

• Referral bonus opportunities
• Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
• Employer-matched retirement saving funds
• Personal and financial wellness programs
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
• Generous tuition reimbursement for qualifying degrees
• Opportunities for professional growth and career advancement
• Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities

What You Will Do

• Coordinate across business, operations, product, and engineering to ensure successful execution of board materials, town hall materials, and large-format meeting materials.
• Prepares executive-level briefings, board materials, and operational performance updates.
• Lead or support high-priority, ambiguous, and complex initiatives that span multiple functions and stakeholders, often with competing priorities and significant organizational impact
• Support monitoring, analysis, and reporting of key operational performance metrics (quality, financial performance, productivity, utilization, service levels, and member/provider experience).
• Establish governance structure and dashboards/scorecards with the Business Implementation team, especially for work that partners with Science & Technology and Health Plan teams in prioritizing system enhancements, optimizing system functionality, and ensuring operational readiness.
• Contributes to prioritization and tradeoff decisions across competing initiatives, balancing business value, technical feasibility, regulatory considerations, and resource constraints
• Anticipates, frames, and escalates strategic risks and decisions, providing clear options and recommendations to senior leadership
• Develops documentation and governance standards and internal controls to strengthen oversight and accountability.
• Serve as a central liaison across Operations, Finance, IT, Compliance, Clinical, and Health Plan leadership.
• Builds strong relationships across departments to ensure alignment, transparency, and effective collaboration.
• Facilitates structured cross-functional meetings to address operational challenges and drive resolution.
• Brainstorms and leads change management efforts to ensure adoption of new processes, systems, or performance expectations.
• Facilitates leadership forums, operational reviews, and strategic working sessions.
• Provides informed recommendations to support strategic planning and operational decision-making.
• Partners with team leads in maintaining foundational materials for leadership forums.
• Ensures materials are prepared and distributed timely with value-driven, decision-oriented content.
• Partners with Implementation Team leads in executing portfolio oversight work, including but not limited to ROI oversight, tech change management, roadmaps, etc.
• Navigates highly ambiguous environments, defining problems, structuring approaches, and aligning stakeholders where direction is not predefined.
• Participates in special projects and performs other duties as assigned.

Licenses and Certifications:

• Program or project management certification (PMP, Lean, Six Sigma) preferred

Education:

• Bachelor's Degree in Business Administration or related field, or equivalent work experience required

Work Experience:

• 5-10 years experience in business/managed care setting, including three years in Medicare and Medicaid required

• Demonstrated experience leading operational improvement initiatives and managing cross-functional projects required

• Proven success driving measurable performance improvement in quality, financial, or service metrics required

• Strong knowledge of healthcare delivery systems, managed care, regulatory requirements, and healthcare technology required

• Experience working with data analytics, reporting tools, and performance dashboards required

• Demonstrated ability to influence and collaborate with senior leaders and cross-functional stakeholders required

• Strong networking, business acumen, and relationship-building skills that translate into organizational impact required

• Excellent analytical, written, verbal, and interpersonal communication skills required

• Experience with health plan operations, claims, utilization management, quality programs, or value-based care preferred