VP, Advisory Operations

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a VP, Advisory Operations based in United States.

This senior leadership role focuses on helping health plans assess and transform their core administration technology and operating models. You will lead advisory engagements spanning claims, enrollment, billing, and member and provider services. Working with operational and technology stakeholders, you will identify root causes behind cost, quality, compliance, and service challenges. You will translate assessment findings into future-state roadmaps, technology blueprints, and compelling transformation strategies. A key part of the role is quantifying business impact and building financial models that resonate with CFOs, COOs, and other executive leaders. You will also bring expertise in automation, AI, regulatory developments, and market trends to shape practical, high-value recommendations.

Accountabilities:

As VP, Advisory Operations, you will lead complex advisory engagements from current-state assessment through transformation planning and business-case development, partnering closely with internal teams and senior client stakeholders.

• Assess health plan core administration technology and operations across claims, enrollment, billing, and member and provider services.
• Identify root causes of cost, quality, compliance, service, and operational performance gaps.
• Translate assessment findings into future-state roadmaps and business and technology blueprints.
• Develop compelling transformation strategies centered on improved efficiency, compliance, service levels, and operational outcomes.
• Quantify opportunities such as cost reduction, service-level improvements, and error reduction.
• Build and defend financial models covering ROI, IRR, cost-benefit analysis, and outcome-based pricing.
• Establish clear accountability across the advisory engagement lifecycle.
• Identify opportunities to use automation and AI-driven processes to reduce manual work and errors.
• Partner with Sales, solution, and delivery teams to ensure advisory recommendations translate into executable operating models.
• Build trusted relationships with stakeholders ranging from operational analysts and directors to C-suite executives.
• Tailor recommendations, narratives, and levels of detail to different audiences, including finance and operations leadership.
• Incorporate competitive intelligence, regulatory developments, CMS and state Medicaid requirements, and evolving platform capabilities into assessments.
• Evaluate previous or ongoing transformation initiatives and diagnose why programs may be stalled, underperforming, or ready to scale.
• Lead and develop teams while balancing hands-on expertise with the appropriate use of subject-matter specialists.

Requirements:

The ideal candidate combines deep health plan operations expertise with strategic consulting, financial modeling, transformation, and executive relationship-building capabilities.

• 10+ years of experience in health plan operations leadership or consulting focused on health plan operations.
• Strong expertise across areas such as claims, enrollment, billing, and member or provider services.
• Demonstrated experience managing teams and leading operational assessments.
• Track record of translating complex findings into board- and C-suite-ready recommendations.
• Experience evaluating transformation initiatives and diagnosing operational or execution challenges.
• Working knowledge of core administrative platforms such as HealthRules Payer, Facets, QNXT, or QicLink.
• Understanding of how technology and operating-model decisions influence cost-to-serve.
• Strong financial modeling capabilities, including ROI, IRR, cost-benefit analysis, and outcome-based pricing.
• Experience structuring and positioning transformation or BPaaS-style solutions for complex, multi-stakeholder opportunities.
• Proven ability to build and maintain relationships with senior operations leaders through the C-suite.
• Strong communication and presentation skills, with the ability to adapt messaging to different levels of an organization.
• Comfortable working with ambiguity, incomplete data, and complex business problems.
• Strong leadership, delegation, accountability, and decision-making skills.
• Ability to determine when to personally address a challenge and when to bring in specialized subject-matter expertise.

Benefits:

• Annual US base salary range of $290,000–$318,000.
• Full-time, permanent employment.
• Fully remote position within the United States.
• Opportunity to work across multiple time zones in a remote or hybrid environment.
• Potential travel based on business needs.
• Executive-level exposure to health plan transformation, technology, operations, and strategy.
• Opportunity to influence high-impact transformation initiatives and business cases.
• Reasonable accommodations available in accordance with applicable accessibility requirements.

How Jobgether works:

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

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We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.