VP of Business Optimization

About the role

Join our Cause to create a person-focused and economically sustainable health care system. As a member of the Health Services Organization (HSO) leadership team, our VP of Business Optimization leads enterprise-level transformation — defining strategic roadmaps, optimizing clinical and operational performance, and driving affordability outcomes — all in service of creating an economically sustainable health care system.

Qualifications

• 12–15+ years of progressive leadership experience in healthcare operations, strategy, consulting, or transformation roles
• Demonstrated success leading large-scale operational transformation and performance improvement initiatives
• Deep understanding of healthcare payer operations, including Utilization Management, Care Management, Pharmacy, Payment Integrity, and Appeals
• Experience driving cost and affordability programs and managing financial outcomes
• Strong executive communication and stakeholder management skills

Preferred Experience

• Led AI, automation, or digital transformation initiatives
• Background in healthcare consulting or enterprise transformation roles
• Advanced degree (MBA, MPH, MHA, or similar)

Skills And Attributes

• Strategic visionary with the ability to define and operationalize multi-year transformation roadmaps
• Skilled at building alignment across clinical, operational, digital, and financial priorities
• Proficient in continuous improvement methodologies such as Lean Agile, Six Sigma, and AI-enabled workflows
• Strong analytical and data-driven decision-making capabilities
• Effective change leader who can engage and align diverse stakeholders at all levels
• Able to translate complex strategies into clear, compelling executive narratives

What You Will Do

• Lead strategic transformation by developing, organizing, and prioritizing a 3-year roadmap aligned to enterprise and HSO objectives — establishing governance, milestones, and value metrics to ensure execution and accountability
• Drive business process optimization across HSO functions (UM, Care Management, Appeals, Pharmacy, Payment Integrity), delivering measurable improvements in operational efficiency, clinical quality, and member/provider experience
• Shape technology strategy by defining business requirements for HSO technology initiatives and partnering with Digital, Technology, and Data teams to accelerate adoption of AI, automation, and digital capabilities
• Lead Cost Stewardship and affordability programs, identifying medical cost drivers, developing targeted initiatives with clinical and finance partners, and ensuring alignment to enterprise affordability targets
• Deliver executive communications and change leadership, including briefings, dashboards, and structured insights that support senior decision-making and drive alignment across the organization
• Build and develop high-performing teams with a focus on accountability, innovation, continuous improvement, and data-driven outcomes

About Cambia

Cambia is a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through.

Why Join the Cambia Team?

• Work alongside diverse teams building cutting-edge solutions to transform health care
• Earn a competitive salary and enjoy generous benefits while doing work that changes lives
• Grow your career with a company committed to helping you succeed
• Give back to your community by participating in Cambia-supported outreach programs
• Connect with colleagues who share similar interests and backgrounds through our employee resource groups

Benefits

• Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits
• Annuity employer contribution to a health savings account
• Generous paid time off varying by role and tenure in addition to 10 company-paid holidays
• Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period)
• Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave)
• Award-winning wellness programs that reward you for participation
• Employee Assistance Fund for those in need
• Commute and parking benefits