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.

Responsibilities

• Develop, organize, and prioritize 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 (Utilization Management, 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.

Requirements

• 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

• Leading 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.

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%.

Schedule

Work from home options are available for most of our roles. To take advantage of this flexible option, employees must have a wired internet connection with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.

Benefits

Information about our benefits is available in the Benefits section. We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.