VP, Advisory Operations

Key Responsibilities:

• Actively engage with teams to assess health plan core administration and operations, identifying root-cause drivers of cost, quality, and compliance gaps.
• Review findings into a future-state roadmap and business blueprint that positions BPaaS as the path to improved efficiency, compliance, and operational outcomes.
• Quantify the opportunity with financial models (ROI, IRR, cost-benefit) and build the business case credible to finance and operations leadership.

What You Need:

• 10+ years in health plan operations leadership or consulting focused on claims, enrollment, billing, and member/provider service.
• Experience evaluating transformation initiatives and diagnosing why a program is stalled or ready to scale.
• Working knowledge of core administrative platforms (e.g., HealthRules Payer, Facets, QNXT) and financial modeling discipline.

Why HealthEdge:

• Build and sustain relationships with client stakeholders from analyst to C-suite, adapting narrative and detail level.
• Bring outside-in perspective on competitive intelligence, regulatory shifts, and platform capabilities.
• Work in a remote-first environment across multiple time zones with a focus on transformation and advisory.

Work Environment:

• Remote, US-based role with travel dependent on company needs.
• Long periods of sitting/standing in front of a computer using video technology.
• Hybrid or remote work across multiple time zones.