Vp, Provider Operations

By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, Alignment Health is revolutionizing health care for seniors! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?

At Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that’s in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career – with us.

Overview of the Role:

The VP will oversee the operations throughout our providers' lifecycle and help build new services for the Management Service Organization (MSO). The ideal candidate should possess a strong healthcare administration, operations management, and leadership background, with a proven track record of driving organizational growth and excellence. Initially, the VP of Provider Operations will lead the following teams while also expanding into other opportunities:

• Provider Services and Relations
• Credentialing
• Delegation Oversight
• Provider data operations

Responsibilities:

Strategic Leadership:

• Develop and execute a strategic Provider Operations vision for Alignment Health, aligned with our overall objectives.
• Identify opportunities to optimize the operations across the provider lifecycle.
• Develop and implement a continuous improvement methodology and framework (Alignment Health Continuous Improvement and Operating System) Drive operational excellence to improve the performance of our provider and key company KPIs.

Operations Management:

• Oversee all aspects of Provider Operations, including provider optimization, provider services, provider relations, credentialling and delegation oversight.
• Develop and implement policies, procedures, and workflows to streamline operations and ensure compliance with regulatory requirements.
• Monitor key performance indicators (KPIs) and metrics to track performance, identify areas for improvement, and drive operational excellence.

Provider Relations and Network Management:

• Supporting operational plans and execution for clinical and market leadership teams
• Collaborate on efforts to expand and strengthen the direct provider network.
• Collaborate with internal stakeholders, including network management, sales, and marketing teams, to drive provider performance efforts.

Financial Management:

• Develop and manage the department budget, forecasting financial performance and ensuring fiscal responsibility.
• Identify opportunities for cost savings to improve profitability, financial sustainability with focus on future scale.
• Monitor and report on financial performance against budget and KPIs, analyze variances, and implement corrective actions as needed. Monitor execution of corrective actions and provide guidance.

Leadership and Team Development:

• Provide strong leadership and mentorship to the team, fostering a culture of collaboration, innovation, continuous improvement, and accountability.
• Recruit, develop, and retain top talent, building a high-performing team.
• Promote professional development and growth opportunities for team members, empowering them to excel.

Supervisory Responsibilities:

Yes

Required Skills and Experiences:

• 10+ years of leadership experience in managed care healthcare administration, with a proven track record of driving organizational growth and excellence.
• Bachelor’s Degree or a combination of education and experience
• Strong knowledge of healthcare industry trends, Provider Operations, regulations, and best practices, with expertise in optimizing operations and engagement.
• Demonstrated leadership abilities with excellent communication, interpersonal, and team-building skills.
• Exhibited operational expertise able to transform operations in high-growth environments.
• Experience in $5bn organization implementing operational excellence programs and leading a continuous improvement function.
• Strong financial acumen and analytical skills, experience managing budgets and a proven track record of reducing operating costs.
• Proven ability to build and maintain strong relationships with healthcare providers, stakeholders, and industry partners.

Please note: All clinical positions are contingent upon successful engagement with Alignment Health’s COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

• DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email careers@ahcusa.com.