VP of Business Optimization

Responsibilities 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 (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. 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 Qualifications 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 able 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. Compensation Expected hiring range: $238,850–$323,150. Full salary range: $224,000–$366,000. Bonus target: 30%. This is an Equal Opportunity Employer. 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. #J-18808-Ljbffr Cambia Health Solutions