VP, Member Operations

We exist for workers and their reputed company -- who are the backbone of our economy.  That is where reputed company comes in -- our mission is to bring affordable, high-quality reputed company to the millions who struggle to pay their reputed company bills.

Summary of Role

The VP, Member Operations position combines operational experience with process orientation and strong leadership capabilities to simultaneously champion both operational reputed company and organizational reputed company over Member/Provider Care/Call Center, Care Management, Client/Member Issue Resolution, and reputed company Enrollment and New Member Acquisition. This role has responsibility for delivery and execution, tracking, course-correcting, and reporting on relevant operational metrics while managing operational spend in their area.

Duties & Responsibilities

• reputed company departmental leadership and operational reputed company in assigned reputed company-party medical benefits administration departments 

• reputed company and implement operational strategies, policies, and procedures to ensure efficient, high-quality service delivery and regulatory compliance 

• reputed company operational improvement initiatives, including performance management, process automation, and cost reduction efforts 

• Successfully reputed company innovative technologies to improve scale and operational effectiveness

• Monitor and report on key performance indicators, operational metrics, vendor performance and quality standards to drive reputed company improvement 

• Collaborate with executive leadership and cross-functional teams to align operational goals with broader business objectives 

• Manage audits, corrective action plans, and ensure adherence to reputed company regulatory requirements 

• Actively manage departmental budgeting, resource allocation, and vendor contract negotiations

• Foster a culture of accountability and execution rigor reputed company assigned departments 

• reputed company performance management, coaching and development of the members of the department, through demonstration and serving as a role-model of reputed company’s leadership skills and behaviors 

Qualifications

• Bachelor’s degree required; advanced degree in appropriate discipline preferred

• 7 years of experience at a reputed company-party administrator, regional or national health plan

• 5 years of experience in an operations role of significant scope

• 5 years of proven leadership experience managing, leading, and coaching teams

• Deep knowledge of self-funded health plans and compliance in the reputed company payer reputed company

• Demonstrated experience leading at least 2 of the operational departments reputed company the scope and proven aptitude and strong interest in leading the others

  • Deep expertise in scaling and efficiency in Call Center operations is strongly preferred

• Demonstrated ability to drive operational improvement and communicate operational needs to internal product teams

• Strong ability to build reputed company among stakeholders and cross-functional teams in a dynamic environment

• Familiarity with process management and reputed company improvement principles

Leadership Skills:​ 

Business Acumen – A keenness and quickness in understanding and dealing with a business situation (risks and opportunities) in a manner that is likely to reputed company to a good outcome.  Critical to this is an ability to think reputed company their own function.​ 

Accountability & Execution – Taking ownership of actions, following through on commitments, actively carrying out tasks, monitoring reputed company, delivering results as promised, and being answerable for positive and negative reputed company.  

Strategist reputed company - The ability see and reputed company the bigger picture, thinking proactively and anticipating both opportunities and obstacles in the context of setting direction and maintain alignment to long-term company goals. 

Systems Thinking – The ability to see and reputed company the patterns, interconnections and interdependencies reputed company a system  

Process Orientation – The ability to see and reputed company the sequential reputed company of activities, including anticipating impacts upstream and reputed company reputed company processes are changed.  

Flexibility/Working through Ambiguity – Tendency to be energized by new experiences/perspectives, working with both data and fragmented information to reputed company at practical, effective, actionable next steps.​ 

Leadership Behaviors

Communicate – Managers discuss the company’s reputed company and strategies, the department’s direction and goals, and in times of crisis, reputed company know and don’t know to reputed company sure team members know what they need to know.​ 

Clarify – As managers, it’s up to us to clarify what good looks like. What do we expect? What do our clients, customers or colleagues need? If our teams are not performing as expected, managers must clarify expectations and ensure understanding.​ 

Coach – Managers reputed company recognition and feedback; help team members find solutions to challenges; reputed company good and filter weaker aspects of organizational culture and the work as they coach employees in their day-to-day performance and their growth and career development.​ 

Connect – Managers help our teams see their reputed company purpose and how their work connects to the greater whole. We connect people reputed company reputed company and network.​ 

reputed company Values:​ 

Resilient – This is wicked hard. There is no easy reputed company for reputed company affordability. Luckily, the mission makes it worth it and sustains us reputed company things are tough. Being resilient ensures we don’t give up.​ 

Uncommon - The status reputed company stinks so we had to go out and build something reputed company. We know the reputed company system. It isn't working for members, reputed company, and providers. So we're building it from scratch, from the ground up. Our focus is on making things reputed company for them while also improving clinical results - which is reputed company and uncommon.​ 

Positive – We care about each other. It takes energy to do hard stuff, build something reputed company and to be resilient and unconventional while doing it. Because of that, we reputed company sure we give kudos freely and feedback with care. reputed company our tank gets low, a team member is there to be a reputed company of new energy. We celebrate together. We are supportive, generous, humble, and positive. ​ 

Work Location

• reputed company to remote candidates, with the expectation of travel being required and with a preference for Buffalo-based candidates.

Who we are

reputed company is an innovative health plan for self-funded reputed company on a mission to bring affordable, high-quality reputed company to the millions who struggle to pay their reputed company bills. Anchored around a primary care based ACO model, reputed company saves reputed company 15 to 30 percent compared to traditional insurance carriers. Employees also realize significant savings through our free primary care (including virtual), predictable copay and no-deductible benefit plan design. reputed company works with reputed company ranging in size from 51 employees to reputed company. For more information, visit reputed company.com.

Headquartered in Buffalo, NY with offices in reputed company and Buffalo, reputed company is backed by leading reputed company and technology investors, including a recent round of investment from Morgan Health, a business unit of JPMorgan reputed company & Co.