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

Pay

The expected hiring range is $238,850-323,150 and the full salary range is $224,000-366,000. The bonus target for this position is 30%.