VP of Business Optimization
$238.85k - $323.15kCambia Health Solutions
Vice President, Business Optimization Oregon, Washington, Idaho, Utah or North Dakota Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are Looking For: Every day, Cambia's dedicated team is living our mission to make health care easier and lives better. 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. As a people leader, you are willing to learn and grow, understanding that leadership is a craft that is continuously honed as you support your team and the lives that depend upon us. Do you have a passion for translating complex strategy into measurable, real-world results? Do you thrive at the intersection of clinical operations, technology, and business performance - leading cross-functional teams toward bold, lasting change? Then this role may be the perfect fit. What You Bring to Cambia Qualifications:
In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include:
Learn more about our benefits.
We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb. 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. If you need accommodation for any part of the application process because of a medical condition or disability, please email View email address on click.appcast.io. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.
- 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
- Experience leading AI, automation, or digital transformation initiatives
- Background in healthcare consulting or enterprise transformation roles
- Advanced degree (MBA, MPH, MHA, or similar)
- 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
- Ability to translate complex strategies into clear, compelling executive narratives
- 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
- 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.
In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include:
- Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
- Annual 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.
Learn more about our benefits.
We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb. 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. If you need accommodation for any part of the application process because of a medical condition or disability, please email View email address on click.appcast.io. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.
Vacancy posted 2 days ago
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