VP, Member & Provider Support Center Services

Accountabilities

• • Provide executive-level strategy, vision, and direction for member and provider support center services, maintaining accountability for operational performance, financial results, and strategic outcomes.
  • Lead support center operations across Medicaid, Medicare, and Marketplace lines of business, including workforce management, reporting, quality assurance, business solutions, telephony, and vendor performance.
  • Develop and execute strategies that strengthen operational excellence, support business growth, and improve member and provider satisfaction, retention, and service quality.
  • Build and maintain strong relationships with senior internal and external stakeholders to ensure consistent and effective shared-service delivery across the organization.
  • Lead the integration of newly acquired employees, teams, and scopes of work while ensuring appropriate organizational structures and operating models.
  • Identify and lead initiatives that reduce administrative costs, improve productivity, increase automation, and deliver more efficient support center operations.
  • Convene cross-functional work groups, establish implementation plans, assign responsibilities and timelines, and measure outcomes against defined objectives.
  • Lead direct employees and oversee external vendors, establishing clear performance expectations and accountability for service quality, cost, compliance, and operational results.
  • Ensure state, federal, contractual, and organizational policies, procedures, and standard operating procedures are consistently implemented across the support center function.
  • Develop and manage departmental budgets, monitor costs, identify efficiency opportunities, and continuously seek ways to reduce unit costs and overall administrative expenses.
  • Design and implement systematic approaches to improve member and provider experiences through greater operational efficiency and effectiveness.
  • Identify and communicate potential financial liabilities, risks, and accrual requirements to senior leadership.
  • Recruit, develop, coach, and retain high-performing teams while establishing clear goals, accountability, and professional development opportunities.
  • Champion a dynamic leadership culture focused on delivering high-quality healthcare and exceptional service to underserved populations.

  Requirements

  • 12+ years of healthcare operations and/or contact center experience, including experience managing large, matrixed teams, or an equivalent combination of relevant education and experience.
  • At least 7 years of management or executive leadership experience.
  • Demonstrated experience leading operations across multiple markets and product lines.
  • Strong knowledge of customer experience, workforce management, data analytics, quality metrics, and operational performance management.
  • Experience developing, managing, and optimizing departmental budgets within defined financial parameters.
  • Proven experience managing account relationships and partnering with senior-level leadership and external stakeholders.
  • Understanding of Medicare, Medicaid, and Marketplace health plans.
  • Experience with Genesys, Salesforce, or comparable contact center and customer relationship management platforms.
  • Demonstrated ability to influence peers and organizational leaders, drive change, and build consensus around strategic initiatives.
  • Ability to envision future-state processes and systems, develop business proposals, obtain stakeholder alignment, and lead implementation.
  • Strong adaptability and flexibility, with the ability to respond effectively to evolving business priorities, new ideas, and changing operating environments.
  • Excellent organizational and time-management skills, with the ability to manage multiple complex initiatives simultaneously and meet critical deadlines.
  • Strong relationship-building skills and the ability to collaborate effectively across a highly matrixed organization.
  • Excellent written and verbal communication skills, with the ability to communicate effectively with executives, employees, vendors, clients, members, and providers.
  • Proficiency with Microsoft Office, including Excel, and other relevant business and operational software.
  • Experience implementing process improvements within a matrixed organization is preferred.
  • Managed care experience is preferred.

  Benefits

  • Competitive compensation package.
  • Comprehensive employee benefits package.
  • Opportunity to lead a large-scale, enterprise-wide support center function across multiple healthcare markets and product lines.
  • Executive-level visibility and influence over operational strategy, financial performance, customer experience, and transformation initiatives.
  • Opportunity to drive automation, process improvement, and innovative solutions across complex healthcare operations.
  • Leadership opportunity spanning internal teams, external vendors, workforce management, quality, analytics, and technology.
  • Professional growth and development opportunities within a large healthcare organization.