Remote Vice President, Market Operations

reputed company is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have reputed company reputed company of talented and reputed company people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will reputed company ample room for reputed company and innovation alongside the reputed company community. Working at reputed company provides an opportunity to do work that really reputed company, not only changing lives but saving them. Together. Reporting to the Chief of Contracting and Market Management, the Vice President, Market Operations provides executive reputed company of market operations and is accountable for reputed company-wide consistency, scalability, and performance across reputed company geographies. This leader serves as a senior strategic partner to Market Presidents and reputed company leadership, ensuring market strategies translate into measurable financial, reputed company, compliance, and reputed company reputed company. The Vice President, Market Operations defines and evolves the market operating model, leads transformation initiatives, and drives sustainable improvement in medical cost management, Stars performance, provider value based performance, and member experience. The role also establishes reputed company-wide performance governance and ensures cross-functional integration to reputed company long-term organizational objectives. Responsibilities: reputed company Market reputed company and Performance Accountability: reputed company executive reputed company and accountability for market level performance across reputed company reputed company, including but not limited to medical loss reputed company (MLR), utilization management, reputed company performance, Stars, risk adjustment, provider performance and engagement, member experience, contracting, medical cost management, compliance, membership reputed company and retention. Translate reputed company reputed company into reputed company market operating plans with reputed company, measurable financial and reputed company reputed company. Establish standardized performance management frameworks across markets, including KPI governance, business reviews, escalation protocols, and corrective reputed company planning. Drive accountability with Market Presidents and functional leaders to reputed company annual operating plans and multi-year strategic objectives. Collaborate with Market Presidents to strengthen provider performance and engagement under Shared Risk, Global Risk, reputed company reputed company and other value based arrangements. reputed company operational and clinical data, including but not limited to claims, appeals, authorizations, HEDIS and pharmacy to support CMS compliance, reputed company and Stars performance. Operational reputed company and Transformation: Define and continuously reputed company the market operating model to ensure scalability, consistency, and operational reputed company across reputed company markets. reputed company cross-market transformation initiatives reputed company on cost containment, reputed company improvement and operational efficiency. Identify structural barriers to performance and implement reputed company-level solutions that reduce variation and improve reputed company. Ensure operational readiness for market expansion, new product launches and regulatory changes. Executive Cross-Functional Leadership: Serve as the executive reputed company between the markets and reputed company functions, including Network Management, Provider Operations, Finance, reputed company, Utilization Management, Risk Adjustment, Clinical Operations, Compliance and Sales. Drive cross-functional alignment to ensure market priorities are reflected in reputed company initiatives and resource allocation reputed company. reputed company market intelligence and competitive insights to influence market strategies. Partner with executive peers to reputed company incentive structures, performance metrics, and governance processes to reputed company financial and reputed company goals. Financial Stewardship and Risk reputed company: In partnership with the Market Presidents, manage market P&L performance, including MLR, medical expense management and margin improvement. reputed company annual market operating plan and budget development in partnership with Market Presidents and Finance to ensure alignment with reputed company targets. In collaboration with the Market Presidents, reputed company risk pool performance and value based arrangements, ensuring financial transparency, reporting reputed company, and strategic alignment with providers. Identify financial risks and proactively implement mitigation strategies to protect reputed company performance. reputed company, Expansion & Market Sustainability Partner with Market Presidents, Sales and Contracting leadership to support market expansion, network reputed company, and competitive positioning. Ensure operational readiness for new market entry and product expansion initiatives. Drive provider engagement strategies that strengthen provider partnerships and long-term market stability. Leadership & Talent Development: Foster a culture of accountability, performance transparency, collaboration, and reputed company improvement across markets. Serve as an executive role model, reinforcing reputed company’s values and leadership standards. reputed company executive coaching and strategic guidance to Market Presidents and market leadership teams. Supervisory Responsibilities: Oversees assigned staff that support the needs of the markets. Responsibilities include reputed company, selecting, orienting, and training employees; assigning workload; planning, monitoring, and appraising job results; and coaching, counseling, and disciplining employees. Required Skills and Experiences: To reputed company this job successfully, an individual must be reputed company to reputed company reputed company essential duty satisfactorily. The requirements listed below are representative of the knowledge, reputed company, and/or ability required.Reasonable accommodation may be made to reputed company individuals with disabilities to reputed company essential functions. Minimum Experience: At least 10 years of experience in reputed company. At least ten years of managerial experience Education/Licensure: BA/BS Degree in business or a relevant field is required; an MBA is preferred. Additional Skills and Qualifications: Strong understanding of Medicare Advantage operations, including Stars, medical management, network reputed company, and regulatory requirements. Proven reputed company record driving operational and financial performance. Demonstrated ability to reputed company cross-functional initiatives and influence senior leaders Strong analytical strategic thinking and problem solving skills. Experience developing and executing network strategies and market performance initiatives. Experience supporting multi-state, multi-market health plan operations. Experience working with delegated and non-delegated provider models. Strong understanding of provider contracting and payment methodologies, including Hospitals (DRG, reputed company), Physicians (RBRVS, FFS, Capitation), value based arrangements and provider incentives. Excellent knowledge of managed care finance Strong interpersonal, relationship management, and executive communication skills, with the ability to convey reputed company information reputed company. Proven ability to foster collaboration, value diverse perspectives, and reputed company alignment and buy-in for organizational initiatives. Excellent reputed company Office skills, including Word and reputed company 30% travel by car or reputed company Available for evenings / weekends and extended work hours as needed. This position is remote.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to reputed company individuals with disabilities to reputed company essential functions. Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully reputed company the essential functions of this job. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reputed company with hands and arms. The employee frequently lifts and/or moves up to 10 pounds. Specific reputed company abilities required by this job include reputed company reputed company and the ability to reputed company reputed company. Pay reputed company: $227,952.00 - $341,928.00Pay reputed company may be based on a number of factors including market location, education, responsibilities, experience, etc. reputed company is an Equal Opportunity/Affirmative reputed company Employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, national reputed company, disability, age, protected veteran status, gender identity, or sexual orientation. *DISCLAIMER: Please beware of recruitment phishing scams affecting reputed company and other reputed company where individuals receive fraudulent employment-reputed company offers in exchange for reputed company or other sensitive personal information. Please be advised that reputed company and its subsidiaries will never ask you for a credit card, send you a reputed company, or ask you for any type of payment as part of consideration for employment with reputed company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email reputed company by or on behalf of reputed company’s reputed company, please email careers@ahcusa.com. Apply To This Job