Vice President, Claims Ops & Configuration
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Job Location:
Monterey Park, NM - USA
Yearly Salary:
$ 180000 - 275000
Posted on:
20 hours ago
Vacancies:
1 Vacancy
Job Summary
About the Role:
We are seeking a visionary leader who combines deep technical mastery with exceptional leadership acumen. As VP MSO Operations you will serve as a strategic architect and operational leader driving innovation and excellence across end-to-end claims operations and system configuration. This role demands a forward-thinking leader who can influence enterprise-wide initiatives optimize performance and deliver scalable solutions that support national growth across all lines of businessMedicare Medicaid Commercial and Health Insurance Exchangewhile navigating complex risk models and delegated arrangements.
Your ability to leverage advanced technology implement continuous process improvements and foster a culture of accountability will be critical to success. This is a highly visible role with significant impact on organizational performance and strategic direction.
Our Values:
Our Values:
- Patients First
- Empowering the Independent Provider
- Be Innovative
- Operate with Integrity & Deliver Excellence
- Team of One
What Youll Do
Strategic Leadership: Define and execute the vision for end-to-end claims operations and configuration ensuring alignment with enterprise objectives and regulatory compliance.
Operational Excellence: Oversee adjudication internal audits provider dispute resolution revenue recovery and system configuration for provider contracts and health plan benefit structures.
Performance Management: Establish and monitor KPIs driving accountability and measurable outcomes across internal teams and external vendors.
Regulatory Stewardship: Maintain deep knowledge of healthcare regulations and proactively address audit findings to mitigate risk and ensure compliance across all operating states.
Innovation & Transformation: Partner with executive leadership to identify and implement automation advanced analytics and process enhancements that improve efficiency and scalability.
Talent Development: Inspire mentor and empower high-performing teams fostering a culture of excellence collaboration and continuous improvement.
Enterprise Collaboration: Provide operational expertise for acquisitions strategic projects and technology implementations that advance organizational goals.
Qualifications
Bachelors degree in business administration health administration or related field (Masters preferred).
12 years of MSO / IPA operations experience including 7 years leading complex delegated claims organizations.
Proven ability to lead large-scale operations with precision and agility in dynamic environments.
Executive presence with strong influencing skills and ability to build trust with senior leaders and external partners.
Expertise in leveraging technology and data to drive operational performance an strategic decision-making.
Environmental Job Requirements and Working Conditions
- This is a hybrid role two days a week in Monterey Park CA.
- The annual salary range is $00.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race religion color national origin gender (including pregnancy childbirth or related medical conditions) sexual orientation gender identity gender expression age status as a protected veteran status as an individual with a disability or other applicable legally protected characteristics. All employment is decided on the basis of qualifications merit and business need. If you require assistance in applying for open positions due to a disability please email us at to request an accommodation.
Required Experience:
Exec
Key Skills
- Change Management
- Financial Services
- Growing Experience
- Managed Care
- Management Experience
- Analysis Skills
- Senior Leadership
- Performance Management
- Process Management
- Leadership Experience
- negotiation
- Analytics
