Senior Vice President, Market Operations

Alignment Health 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 built a team of talented and experienced people who are passionate about transforming the lives of the seniors we this fast-growing company you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters not only changing lives but saving them. Together.

Responsibilities:

Enterprise Market Strategy and Performance Accountability:

• Translate enterprise strategy into scalable market operating plans with clear and measurable financial operational and quality outcomes.
• Provide executive oversight and accountability for market level performance across all regions including but not limited to medical loss ratio (MLR) utilization management quality performance Stars risk adjustment provider performance and engagement member experience contracting medical cost management compliance membership growth and retention.
• Establish standardized performance management frameworks across markets including KPI governance business reviews escalation protocols and corrective action planning.
• Drive accountability with Market Presidents and functional leaders to achieve annual operating plans and multi-year strategic objectives.
• Provide risk adjustment performance accountability oversight across markets ensuring consistent coding accuracy provider engagement and documentation integrity to optimize RAF performance and support CMS compliance and financial outcomes.
• Advance value-based care performance in collaboration with Market Presidents to strengthen provider performance and engagement under Shared Risk Global Risk Gain Share and other emerging payment models.
• Leverage advanced analytics and data including but not limited to claims appeals authorizations clinical HEDIS and pharmacy to drive CMS compliance quality improvement and performance optimization.

Operational Excellence and Transformation:

• Define implement and continuously evolve the market operating model to ensure scalability consistency and operational excellence across all markets.
• Lead cross-market transformation initiatives focused on cost containment quality improvement and operational efficiency.
• Drive implementation of risk adjustment optimization initiatives standardizing workflows tools and provider processes to improve coding completeness documentation accuracy and overall RAF performance consistency across markets.
• Identify systemic barriers to performance and implement innovative enterprise-level solutions to improve outcomes and reduce inefficiencies.
• Ensure operational readiness and executive excellence for market expansion new product launches regulatory changes and emerging business models.

Executive Cross-Functional Leadership:

• Partner with enterprise leadership and cross-functional teams including Network Management Provider Operations Finance Quality Stars Utilization Management Risk Adjustment Clinical Operations Compliance Sales and Product to align performance metrics and governance frameworks that drive achievement of financial and quality objectives.
• Drive enterprise alignment to ensure market priorities influence corporate strategy investment decisions and resource allocation decisions.
• Leverage market intelligence competitive insights and regulatory trends to inform enterprise strategy and market positioning.

Financial Stewardship and Risk Oversight:

• Provide executive oversight of market P&L performance including MLR revenue optimization medical expense management and margin expansion.
• Lead enterprise market planning including annual operating plans long-term planning and budgeting in partnership with Market Presidents and Finance.
• In collaboration with the Market Presidents oversee risk pool performance and value based arrangements ensuring financial transparency reporting integrity and strategic alignment with providers and enterprise objectives.
• Oversee the financial impact of risk adjustment performance across markets ensuring RAF accuracy revenue integrity and proactive identification of risks and opportunities that affect Medicare Advantage margin performance.
• Identify financial risks and proactively implement mitigation strategies to protect enterprise performance.
• Drive accountability for achieving sustainable margin improvement while maintaining quality and compliance standards.

Growth Expansion & Market Sustainability

• Partner with Market Presidents Sales Product and Contracting leadership to drive market expansion network strategy and competitive positioning.
• Ensure operational readiness and scalability for new market entry product expansion initiatives and membership growth.
• Ensure risk adjustment readiness and scalability in new and expanding markets embedding coding accuracy provider education and documentation workflows into market entry and growth strategies.
• Drive and execute provider engagement strategies that strengthen provider partnerships and long-term market stability.

Leadership & Talent Development:

• Build and sustain a high-performance culture grounded in accountability transparency collaboration and continuous performance improvement across markets.
• Serve as an executive role model reinforcing Alignment Healths values and leadership standards.
• Provide executive coaching and strategic guidance to market leadership teams.
• Lead organizational change management efforts to ensure successful adoption of strategic initiatives.

Additional Strategic Responsibilities

• The scope of this role and its responsibilities will continue to evolve to support enterprise-wide strategic initiatives and organizational priorities.
• Lead or support high-impact cross-functional initiatives and special projects as assigned by executive leadership.
• Continuously evaluate and evolve the market operating model to align with enterprise strategy industry trends and emerging business needs.

Supervisory Responsibilities:

Oversees assigned staff that support the needs of the markets. Responsibilities include recruiting selecting orienting and training employees; assigning workload; planning monitoring and appraising job results; and coaching counseling and disciplining employees.

Required Skills and Experiences:

To perform this job successfully an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge skill and/or ability accommodation may be made to enable individuals with disabilities to perform essential functions.

Minimum Experience:

• 1215 years of progressive leadership experience in healthcare with significant experience in Medicare Advantage.
• 10 years of executive leadership experience managing large multi-market teams and complex operations.

Education/Licensure:

• BA/BS Degree in business or a relevant field is required; anMBA is preferred.
• Additional Skills and Qualifications:
• Deep expertise in Medicare Advantage operations including Stars risk adjustment medical management network strategy and regulatory requirements.
• Demonstrated success leading enterprise-scale operational and financial performance improvement initiatives.
• Deep knowledge of risk adjustment coding accuracy documentation integrity provider education and engagement strategies prospective and retrospective chart review programs and CMS audit readiness and compliance.
• Proven ability to influence executive stakeholders and drive cross-functional alignment in a matrixed environment.
• Strong strategic analytical and problem solving capabilities with the ability to translate insights into action.
• Experience developing and executing network strategies and market performance initiatives.
• Experience leading 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 per diem) 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 complex information clearly.
• Proven ability to foster collaboration value diverse perspectives and gain alignment and buy-in for organizational initiatives.
• Excellent Microsoft Office skills including Word and Excel Ability to travel up to 40% as needed
• Available for evenings / weekends and extended work hours as needed

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 enable individuals with disabilities to perform essential functions.

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform 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 reach with hands and arms. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Pay range may be based on a number of factors including market location education responsibilities experience etc.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin disability age protected veteran status gender identity or sexual orientation.

*DISCLAIMER:Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal be advised that Alignment Health and its subsidiaries will never ask you for a credit card send you a check or ask you for any type of payment as part of consideration for employment with our you feel that you have been the victim of a scam such as this please report the incident to the Federal Trade Commission at If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Healths talent acquisition team please email.