Vice President of Operations

Job Description

Vice President of Operations

Job Summary

Seeking a seasoned and strategic Vice President of Operations to lead and optimize operational performance within a Third-Party Administration (TPA) organization. This executive role is pivotal in overseeing health benefits administration operational infrastructure compliance client service delivery and cross-functional performance. The successful candidate will ensure scalable growth regulatory compliance and exceptional client outcomes.

Compensation Package

• Base Salary: $130000 - $160000 per year
• Type: Permanent full-time position
• Work Schedule: 5 days per week onsite

Responsibilities

• Provide executive leadership and strategic oversight for all operational functions including claims administration eligibility billing customer service and compliance.
• Drive operational excellence through process optimization performance metrics automation and system enhancements.
• Oversee medical claims operations ensuring accuracy timeliness compliance and cost containment.
• Partner with underwriting finance and sales teams to support pricing strategies risk evaluation and client profitability.
• Maintain a strong working knowledge of carrier relationships stop-loss arrangements and network contracting.
• Ensure compliance with ERISA HIPAA ACA FLSA and applicable state and federal regulations.
• Lead and mentor department leaders fostering a high-performance accountable and client-focused culture.
• Develop KPIs and reporting dashboards to monitor operational effectiveness and financial performance.
• Identify and implement scalable infrastructure to support organizational growth.
• Serve as an executive liaison with key clients brokers carriers and vendor partners.

Qualifications/Requirements

Required:

• 10 years of executive leadership experience in Third-Party Administration (TPA) within health benefits.
• Demonstrated experience overseeing health plan operations and claims administration.
• Strong knowledge of self-funded health plans trust structures and plan funding models.
• Proven ability to manage multi-department operations and drive measurable performance improvements.
• Experience with regulatory compliance and risk management in employee benefits administration.
• Exceptional leadership communication and organizational skills.

Preferred:

• Medical claims adjudication experience.
• Direct experience working for or closely with a medical carrier.
• Underwriting experience including risk analysis and plan pricing support.
• Experience with benefits administration platforms and claims processing systems.
• Bachelors degree required; advanced degree (MBA MHA or related field) preferred.

Leadership Competencies

• Strategic thinker with operational depth.
• Data-driven decision maker.
• Expertise in change management.
• Strong financial and business acumen.
• Collaborative cross-functional leadership.
• High integrity and accountability mindset.

#LI-JF1